Analysis: Health care fades in Republican gubernatorial primary

Sunday, July 20, 2008 | 5:55 p.m. CDT; updated 11:48 a.m. CDT, Thursday, September 3, 2009

JEFFERSON CITY — Health care, once figured to be the predominant issue in the Missouri governor’s race, has quietly faded to the background as the primary election approaches.

With the Aug. 5 primary just two weeks away, neither Republican gubernatorial candidate has outlined any specifics about how to make health care more accessible and affordable to Missourians, despite expressing that as a goal.

Nor have they highlighted health care in any of their many TV ads.

Nor do they intend to develop a detailed health care proposal and ad campaign before the primary election.

The estimated 770,000 Missourians lacking health insurance — whose ranks have risen in recent years — will have to wait for the general election to hear more.

Spokesmen for Congressman Kenny Hulshof and Treasurer Sarah Steelman each say they will flesh out their health care proposals if they advance from the Republican primary to face Democratic Attorney General Jay Nixon.

Nixon has made it a campaign priority to restore the Republican cuts to the Medicaid health care program for the poor. Spokesman Oren Shur said Nixon plans to announce a more detailed plan this week, also “expanding access for children, making our system more efficient and helping families afford coverage.”

The fading of health care as a headline issue began when Republican Gov. Matt Blunt announced in January that he would not seek re-election. It’s diminishment has been aided by the emergence of other pocketbook issues — declining jobs and rising gas and food prices.

At the time of his announcement, Blunt was advocating for his Insure Missouri plan that would expand government-subsidized health care to low-income workers. It was expected to be a counterpoint against Nixon’s criticism of the Medicaid cuts in a 2008 campaign.

But Blunt’s proposal languished in the legislature, failing to even receive House debate, largely because of opposition from fellow Republicans.

Hulshof and Steelman both have defended Blunt’s Medicaid cuts as necessary to balance the budget, and both generally have embraced his Insure Missouri proposal.

As they gathered for the Republicans’ annual Lincoln Days event in February, Hulshof in particular indicated he would emphasize health care in his campaign.

“When you ask people at the supermarket, ’what’s the top issue?’ they will often think of health care,” Hulshof said in a speech to Republicans.

In an interview with The Associated Press at that same event, Hulshof said his own health care proposals would depend partly on the fate of Blunt’s Insure Missouri plan. After the legislature adjourns in mid-May, Hulshof said, he could have a more in-depth discussion of health care.

“What can we do here in the state for small business owners? What can we do for private individuals to have access to health care? How do we make sure that there is accessibility for all Missouri citizens? Those are the kinds of decisions and discussions we should be having,” Hulshof said in February.

Hulshof continues to list health care as an issue on his campaign fliers and Web site. A spokesman explained why he has offered no further specifics.

“He wants to get this right, and he wants to have it with a good deal of detail,” said Hulshof spokesman Scott Baker. “So if that takes some time to do it right, so be it.”

Steelman does not highlight health care among the issues on her Web site.

But, Steelman spokesman Spence Jackson said, “I don’t want you to think that Sarah doesn’t think health care is important. She does. If she’s fortunate to win the (Republican) nomination, she will come out with a health care plan.”

Polling indicates the Republican gubernatorial candidates may not need to highlight health care in the primary.

A recent poll by the St. Louis Post-Dispatch and television station KMOV found that health care ranked as a top issue for likely gubernatorial voters in general. But among a 500-person sampling of likely Republican voters, health care finished fifth in importance — well behind the No. 1 Republican issue of taxes and spending.

So it’s fitting the Steelman and Hulshof have hit hard upon the tax-and-spend theme. Both proclaim themselves fiscal conservatives who back tax cuts while Steelman has tried to cast Hulshof as a big-spending Washington politician.

The health care fade is not unique to Missouri’s Republican gubernatorial race. Health care also has become overshadowed nationally by concerns about the economy and high gas prices.

When an audience member asked Republican presidential candidate John McCain a health care question at a Kansas City campaign event last week, McCain responded that it probably would have been the first topic of discussion six months ago. Now, McCain added, “the price of gas has obviously superseded it with our energy challenges.”

In politics, there is a hierarchy of issues.

“Generally what you find is the economy, health care, education are sort of the basic issues that have to be addressed in any gubernatorial campaign,” said political scientist Peverill Squire at MU. “But at times they get pushed aside in favor of the more topical issue of the moment. And currently, the economy and gas prices are swamping everything else in terms of voter interest.”

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