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Nixon Renews His Push For Expanding Medicaid

As the state – and his reputation – seeks to move beyond Ferguson, Missouri Gov. Jay Nixon is rekindling his longstanding pitch in favor of expanding Medicaid.

And Nixon may be seeking to subtly link the expansion with Ferguson’s headline-grabbing racial and economic unrest, by emphasizing what the state has been giving up in federal money – and what he said has resulted in less help to those who need it.

Gov. Jay Nixon
Credit Jo Mannies | St. Louis Public Radio
Gov. Jay Nixon

”Let’s be honest, for just a second. The kind of real and lasting investments that our communities need to move forward are not free,” the governor said during an address Tuesday to the St. Louis Regional Chamber and Growth Association.

“Preschool programs for working families are not free. Seed capital for small startups is not free. Science teachers and school lunches are not free. … Worker training is not free. To pay for these efforts, you need some level of revenue. And that means this race to the bottom has got to stop.”

His comments were specifically directed at the tax breaks that he recently vetoed, and the tax cuts that the General Assembly has set in motion by overriding his earlier veto.

But Nixon brought up that fiscal debate right after detailing the financial strain that he said was beginning to plague Missouri’s health care industry. The culprit, he implied, were Republican legislative leaders who were pressing for tax breaks while continuing to oppose the expansion of Medicaid, as sought by the federal Affordable Care Act.

“This has got to be the year we get Medicaid done,’’ Nixon said.

Expanding Missouri’s Medicaid program would add about 300,000 people to the rolls. Most of those residents are low-wage workers whose jobs don’t offer health insurance.

Nixon, a Democrat, noted that the federal government is paying all the expansion costs through 2016 (and at least 90 percent thereafter) and emphasized that Missouri has given up $2 billion in federal money that would have been designated for 2014.

Instead of adding tens of thousands of health care jobs, as projected, Missouri is beginning to shed them, the governor said, because of the loss of the federal money. The federal government is phasing out a separate aid program to hospitals that care for the uninsured, because those people would have been covered by expanding Medicaid.

The legislative opposition, he said, now is contributing to the state’s economic slowdown in the health care industry.

“One out of every six jobs (in Missouri) is in the health care sector,” the governor said. “Until we get right on this, and bring back these dollars and expend them on improving both access and quality of care in our state, we’ll begin to see what we’ve seen unfortunately in many parts of the state: The loss of jobs, quite frankly, in the health care sector.”

Since the last legislative session ended in May, he said, at least two states with Republican governors – Pennsylvania and Indiana – have crafted Medicaid expansion programs that have allowed them to accept billions of federal dollars, thus boosting their overall economy.

The upshot, said Nixon, is that states that are expanding Medicaid are “getting an economic advantage."

Missouri, he asserted, is now being left behind.

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