UM curators urge agreement on Medicaid expansion in Missouri

Friday, April 12, 2013 | 7:32 p.m. CDT

ROLLA — The UM System Board of Curators voted Friday to support a compromise about Medicaid expansion in Missouri. The board also heard reports from the University of Missouri System chancellors on the futures of their campuses.

In a unanimous vote, the curators agreed to urge the General Assembly and Gov. Jay Nixon to reach an agreement on whether to accept money from the federal government to expand Medicaid coverage under President Obama's Affordable Care Act. They did not advocate one way or another on the expansion.

If the state's public health insurance program were expanded, MU Health Care would receive compensation for the care it now provides Missouri citizens not eligible for Medicaid, according to documents provided at the board's meeting. MU Health Care provided more than $50 million in uncompensated health care last year.

Health care expansion would provide Medicaid coverage to people at or below 138 percent of the poverty level, according to an MU School of Medicine study. That's just more than $15,850 for a household of one and about $32,500 for a household of four. Roughly one in seven Missourians are already eligible for Medicaid, according to the Missouri Foundation for Health.

Currently, the Affordable Care Act will enable 525,000 Missourians to buy subsidized health coverage when it takes effect next year. In Boone County, 12,500 residents will be eligible.

Gov. Nixon has called Medicaid expansion under Obama's health care law a top priority for this legislative session, but he has yet to find common ground with state senators opposed to the plan, according to the Associated Press. 

The board concurred, after a lengthy discussion, that the revenue boost the system and MU Health Care would receive under Medicaid expansion was worthy of supporting a compromise solution in Jefferson City.

"One of our jobs is to be advocates," curator Don Downing said. "It's important that we sound off and give our view on how this issue directly affects the system."

Early in the discussion at the Missouri University of Science and Technology, some board members were concerned that directly supporting an expansion of Medicaid in Missouri — Downing's original intent — was too political and outside the scope of the nonpartisan body.

"Medicaid is a political hot potato in Jefferson City," curator David Bradley said. "I think we risk alienating one branch of government to appease another."

Last year, individual curators supported the failed proposition B, an increase in tobacco tax that would have generated funding for higher education, but the board did not speak as a whole, according to meeting documents.

When curator Ann Covington suggested Friday that the board draft a resolution that encourages a compromise about Medicaid expansion but does not support it either way, an agreement was met and the language finalized and finally passed.

Earlier in the meeting, UM System President Tim Wolfe addressed the tug of war between the Republican-led legislature against expansion and Nixon, a Democrat, who is for it: “If we turn down Medicaid, do we watch our federal dollars go to other states?” he told the board. “Do we watch regional hospitals close because they’re on thin margins anyway?”

Strategy statements

MU Chancellor Brady Deaton came before the board Friday to map MU’s game plan for staying nimble in an evolving higher education environment.

In his presentation, Deaton explained to the board that MU will use tactics similar to those in its Mizzou Advantage initiative to remain competitive nationwide in the face of a consistent decline in state funding, a diminishing availability of federal research funds and a potential decrease in enrollment growth.

Deaton and the system’s three other chancellors delivered their campus’ strategy statements, a step in the system’s overall strategic planning campaign, at the board’s meeting. The system required each campus to draft a thesis-like strategy statement to define how it will distinguish itself within the system, compete nationally and achieve specified goals over the next several years. 

"Don’t throw these (strategy statements) away," Wolfe said. "You can hold me accountable to these statements. I’m measuring myself by this, and I’m comfortable that all of the leaders on campus will, too."

The statements won’t be finalized until the curators' June meeting, when the campuses will list specific, time-bound actions that further explain how they’ll implement the tactics.  

One tactic, Deaton said, is hiring more tenured, tenure-track and non-tenure-track faculty.

Within the next five years, Deaton plans for MU to hire an additional 100 tenured and tenure-track faculty, or 20 per year. He said he also expects MU to hire 100 more non-tenure-track faculty during the same time period.

Deaton said much of the revenue to pay for the potential tenured and tenure-track faculty will come from a private fundraising campaign that's still in its early stages but so far has raised $250 million.

Later, at a news conference, Wolfe was asked how much more specific the campus strategic statements would be when they are next presented in June. Using Deaton's MU plan as an example, Wolfe said he expects more specifics — for example, which departments would get more faculty.

"We can tell you we'll catch a fish, but that doesn't tell you everything," Wolfe said about expecting granular plans from each campus.

Other items of note from the board's meeting:

The next board meeting is June 13-14 at MU.

Supervising editor is Elizabeth Brixey.

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Jimmy Bearfield April 12, 2013 | 9:50 p.m.

"If we turn down Medicaid, do we watch our federal dollars go to other states?”

No. A recent AP story refuted this myth:

"There is no tax specifically earmarked for Medicaid. If Missouri fails to expand Medicaid — and thus fails to draw down more than $900 million in federal funds in 2014 — that money is not redistributed to other states. Additionally, there is no requirement for Missouri's forgone Medicaid money to be spent on health care. The federal government could use the savings to lower its debt or spend it on national defense or other domestic programs."

(Report Comment)
Ellis Smith April 13, 2013 | 7:20 a.m.

So, the Curators have tackled the Medicaid issue, have they?

When are the Curators going to tackle issues actually dealing with the DIRECTION and OPERATION of this university? Is its current operation and direction so satisfactory that the Board has time to spend discussing marginally-related matters? For example, is the issue of current faculty pay - at all four campuses, not just the so-called "flagship campus - "satisfactory"?
I suggested last week that the University of Missouir's so-called "System" is a sham and a farce, and that it has been for years. Thank you for illustrating my point; you have done so much better at illustrating it than I ever could.

In a 1996 interview with MU's "Maneater" newspaper, John ("Woody") Cozad called the Curators, of which he'd been a Curator for six years, "a debating society." Well, you've certainly gone beyond that: today you don't even appear capable of intelligent debate.

BTW, Cozad's only degree from this "System" was from MU, not from UMKC, UMSL or MS&T. More recently Cozad, when interviewed by phone by one of the Columbia daily newspapers, said it might be in the best interests of UMKC, UMSL and MS&T if the "System" were disbanded.

If the ship subsequently sinks, we'd prefer not to be forced to go down with it.

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