Missouri House Democrats push for Medicaid expansion in the state

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JEFFERSON CITY - Democratic lawmakers said they fear rural hospitals will be forced to close if new legislation expanding Medicaid in Missouri is not passed.

House Minority Floor Leader Jake Hummel, D-St. Louis City, filed legislation on Monday, February 18, that would expand Missouri's Medicaid system. Hummel, along with the House Democratic Caucus, presented his bill at a press conference. He said he believes Medicaid is the biggest issue in the state.

Pemiscot Memorial Hospital CEO Kerry Noble spoke at the press conference. Noble said his hospital will be at risk for closing if the expansion is not passed.

Pemiscot Missouri is located in the Southeast Missouri and 30 percent of the population lives below the federal poverty line. Noble said the hospital has a $50 million operating budget, but $9 million of that is spent on uncompensated care. If Medicaid is not expanded, Nobel said the hospital would lose around $1 million annually, which would put the hospital at a great risk of closing.

"We will jeopardize our facilities, we will no longer be in existence if passage of this expansion does not occur," Noble said.

The Senate Appropriations staff estimates that by 2020 $250 million would be cut from federal funding for hospitals for uncompensated care.

Hummel said Medicaid expansion, which would expand eligibility to 138 percent of the federal poverty level to leverage $8.2 billion in federal investment in the state, would also create 24,000 jobs and bring $9.6 billion in additional investments in Missouri economic activity. He said expansion would provide 300,000 Missourians with access to health care.

Rep. Jay Barnes, R-Jefferson City, said he believes Medicaid expansion is not the way to go. He said expansion will receive little support from House Republicans.

"I think there is interest in transforming Missouri's Medicaid system into what would be the most free-market based Medicaid system in the entire country," Barnes said. "I think there's no interest in simply expanding Medicaid envisioned under Obamacare."

Barnes has been working on a piece of legislation that he said would transform the state's Medicaid program to deliver better care. Barnes said "stay tuned" for more information on his legislation.

During the annual State of the State Address in January, Gov. Jay Nixon said Medicaid expansion is "the right thing to do."

"Strengthening Medicaid will strengthen our economy," Nixon said in his address.

However, Nixon said he would support including a provision that would roll back Medicaid expansion if Washington does not honor its financial commitment.

Rep. Jeanne Kirkton, D-Webster Groves, said this legislation is a golden opportunity to grow Missouri's economy by "accepting the federal dollars to extend health care to more hardworking, uninsured Missourians." She said bringing the federal tax dollars back to Missouri is expected to decrease the rate of uninsured in Missouri in different regions of the state anywhere from 26 to 31 percent.

"More access to care, less medical debt and lower mortality is not only a public good, it's good for our economy," Kirkton said.

She said failing to expand Medicaid will weaken Missouri hospitals and maybe force some hospitals to close, which will stifle Missouri's economic growth.

"This is too important of an issue to sweep under the rug," Hummel said. "We're willing to work across the isle and get something done."