Missouri Gov. Jay Nixon open to Medicaid expansion alternative

Thursday, March 28, 2013 | 3:52 p.m. CDT

JEFFERSON CITY — Missouri Gov. Jay Nixon pushed again for a Medicaid expansion Thursday but said he's open to alternatives pursued in other states that would use federal money to buy private insurance for lower-income adults.

The Republican-led legislature has repeatedly rejected a straight expansion of Medicaid eligibility as called for under President Barack Obama's health care law, yet the Democratic governor has continued to try to build public support for it. He discussed the Medicaid expansion Thursday morning with Democratic lawmakers at the Capitol, then was traveling to Hermann and Perryville for news conferences touting the economic and health benefits of the plan.

Nixon said in a brief interview at the Capitol that he is open to considering an Arkansas model that would use federal Medicaid money to purchase private insurance policies through online insurance marketplaces, instead of enrolling new adult participants in the traditional government-run program.

"There are a lot of ways to get to where we need to get, and clearly one of those ways is to use the tool of a health care exchange to provide some of that coverage," Nixon said. He added: "Certainly, we'd be open to doing that."

The 2010 federal health care law called for states to expand Medicaid to adults earning up to 138 percent of the poverty level, which is more than $15,800 for an individual or $32,500 for a family of four. A U.S. Supreme Court ruling last year made that optional for states. Nixon embraced the Medicaid expansion after winning re-election last November. He has since held more than 25 news conferences around the state promoting the Medicaid expansion.

States that implement the Medicaid expansion can receive three years of full federal funding for it, beginning in 2014. States then would gradually pick up a share of the costs, topping out at 10 percent in 2020. Nixon had proposed including more than $900 million of federal funds in Missouri's 2014 budget for the Medicaid expansion.

The budget plan adopted by the Republican-led House leaves that Medicaid money out. But a House committee is scheduled to vote next week on a Republican alternative to the Medicaid expansion that would cover fewer adults than called for under Obama's law and remove thousands of children from the Medicaid rolls. The GOP plan would provide Medicaid coverage through a competitively bid private insurance model.

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