Nixon plan expanding Medicaid rejected by House

Tuesday, March 10, 2009 | 1:33 p.m. CDT; updated 11:27 a.m. CDT, Thursday, September 3, 2009

JEFFERSON CITY — As Gov. Jay Nixon traveled the state Tuesday to pitch his proposal for expanding the state's Medicaid rolls, the House rejected a Democratic attempt to endorse part of the idea.

Nixon, a Democrat, has proposed adding 35,000 adults to Missouri's Medicaid health care program for the poor by using $52 million from hospitals that would then attract $93 million in federal funds.

The hospitals would pay an additional $20 million annually in taxes and forgo $32 million that the facilities normally would get from the state to partially reimburse them for the costs of treating uninsured patients.

While Nixon was holding his last news conference in a two-day state tour about his proposal, the Republican-led House voted 84-69 to reject a Democratic attempt that supporters said would help adopt the idea.

Lawmakers gave first-round approval to legislation extending until 2011 a hospital tax that was set to expire June 30. Democrats tried to add an amendment that would have allowed willing hospitals to increase what they pay for the tax and use that money so the state could pay for more health care.

House Budget Committee Chairman Allen Icet said he was reluctant to increase the tax because he wasn't sure if the state's hospitals backed the idea. Icet, R-Wildwood, said lawmakers could always go back and add the Democratic amendment when the Senate considers the bill.

The trade group for Missouri's hospitals has endorsed Nixon's idea.

Nixon spokesman Jack Cardetti said after the House vote that the amendment wasn't needed to implement the plan and that the governor's office expects that the proposal would be implemented through the state budget.

Rep. Chris Kelly, a Democratic leader on the House Budget Committee, said the proposal wouldn't cost the state any money and that its rejection shows that House Republicans are being controlled by members who oppose any government-funded health care.

"The vote says that we and the hospitals still have some educating to do," said Kelly, D-Columbia.

Nixon last year campaigned heavily on reversing cuts to the state's Medicaid program made in 2005 by former Gov. Matt Blunt and Republican lawmakers. His proposal is to raise the income threshold for adults to qualify for Medicaid.

Currently, for an adult with two children, the maximum income level is $292 a month. Nixon's plan would increase that to $763 a month.

But House Republicans have been skeptical of expanding the state's Medicaid program. Icet has said he's concerned Nixon's idea would put lawmakers on a path of expanding welfare, leading to future costs. The House Republican caucus last week balked when the governor's plan was proposed to them.

During floor debate Tuesday, critics of the Democratic amendment said Missouri lawmakers shouldn't be so cavalier about using federal money.

"If we turn down this amendment, what we're really saying to Missourians is that whether it's federal taxes or state taxes, this House is protecting the taxpayer from paying anything more than they have to," said Rep. Ed Emery, R-Lamar.


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