COLUMBIA — The Columbia City Council is asking the state legislature to accept Medicaid expansion as provided by the Affordable Care Act.
By a 5 to 1 vote Monday, the council passed a nonbinding resolution that expresses support for Medicaid expansion in Missouri, saying the expansion would improve the health of Missouri families, reduce the costs of health care access and save and create thousands of jobs across the state.
Mayor Bob McDavid said at the council meeting that expanding Medicaid in Missouri would make 221,000 people eligible for Medicaid, create 4,000 jobs in the state in 2014 and increase tax revenues by $856 million by 2020.
"This does not even speak to the humanitarian aspect of it," said McDavid, who voted for the resolution.
The Affordable Care Act created new regulations on health insurance providers, established the health insurance exchanges and expanded Medicaid to cover more people, according to the Centers for Medicare & Medicaid Services.
Some states sued the federal government to be excluded from the new health care law. In June, the U.S. Supreme Court allowed most parts of the law to stand but found mandatory Medicaid expansion unconstitutional, opening the door for states to opt in or out.
If states choose to expand Medicaid, the federal government would pay all costs associated with the expansion for three years. After three years, the federal government would gradually reduce its subsidy to 90 percent by 2020, according to the Centers for Medicare & Medicaid Services.
Third Ward Councilman Karl Skala also voted for the resolution Monday night, declaring it a matter of "the public good" and saying that it "has to do with expressing our opinion in a democratic fashion."
The lone dissenting voice on the council was Laura Nauser. Nauser cited federal government debt and deficit as one of her reasons for not supporting the resolution.
"We have a federal government who is $17 trillion in debt. We have $90-plus trillion in unfunded liabilities for such programs as Medicaid, Medicare and Social Security,” Nauser said. She said supporters of the resolution should contact their state and federal representatives, believing that this matter is not for the city to get involved in.
Missouri Rep. Stephen Webber, D-Columbia, said Monday before the meeting that he is in favor of the Medicaid expansion. Webber said that because of Columbia's large number of hospitals, the area could see millions of dollars in revenues added to the local economy.
Webber, a member of the House's Medicaid Transformation Committee, also said Medicaid expansion could save the state millions of dollars per year. Because the federal government subsidizes the cost of Medicaid expansion, costs currently borne by the state would be shifted to the federal government, Webber said. He said the bipartisan committee estimates a minimum savings to the state of $43 million annually, even after the federal government reduces its subsidy to the 90 percent level.
"There's zero debate that this would be a positive thing for Columbia," Webber said.