Missouri study says Medicaid expansion would create jobs, revenue

Friday, February 21, 2014 | 4:26 p.m. CST; updated 7:00 p.m. CST, Friday, February 21, 2014

JEFFERSON CITY — Missouri would get 24,000 new jobs if the state expands eligibility for its Medicaid program, according to a report released Friday, but the analysis is unlikely to sway the reluctant Republican-led legislature.

The Department of Economic Development projects the new jobs would bring in $9.9 billion in new wages and generate $402 million in state revenue over the next eight years.

Gov. Jay Nixon has asked lawmakers once again to use $1.7 billion next year from the federal government to expand eligibility for about 300,000 people. But the Republican-led legislature has repeatedly rejected expansion.

Supporters say expanding Medicaid creates health care jobs by increasing access to care. The department's study estimates that expanding Medicaid would create more than 4,000 jobs in St. Louis County alone, an additional 2,000 in Kansas City and 1,700 in mid-Missouri. The report emphasizes that its numbers are conservative and that "actual impacts may be more pronounced."

Nixon's plan would add adults earning up to 138 percent of the federal poverty line — a little less than $33,000 annually for a family of four — to the state's Medicaid rolls.

That aligns with the terms of President Barack Obama's health care law, which means the federal government will pick up the tab for the first few years. In future years, states must gradually start picking up 10 percent of the expansion costs. The department's analysis contends the influx of federal dollars will spur economic growth.

Those arguments are unlikely to persuade Republicans who oppose the expansion. Republicans rejected an expansion in 2013 after an MU study projected job gains.

Republicans have said the state couldn't afford expansion if the federal government reneged on its funding promises. They have also said the current system needs to be improved before more people are added.

Rep. Noel Torpey, R-Independence, introduced legislation this week that would add some people to Medicaid while helping others purchase private health plans on the exchange marketplace.

A Medicaid bill pending before a Missouri Senate committee would not expand coverage but would change the way the program is administered. The bill would expand managed care polices statewide for parents and children instead of making them available only in certain counties as is currently the case. It also would cover disabled and senior residents through "accountable care organizations," consisting of partnerships among a hospital system, doctors and pharmacists who would coordinate care.

Missouri's Medicaid program currently covers about 850,000 people at an annual cost of nearly $9 billion, most of which comes from the federal government.

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