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KBIA’s Health & Wealth Desk covers the economy and health of rural and underserved communities in Missouri and beyond. The team produces a weekly radio segment, as well as in-depth features and regular blog posts. The reporting desk is funded by a grant from the University of Missouri, and the Missouri Foundation for Health.Contact the Health & Wealth desk.

More Medicaid debate expected in the 2014 Mo. legislative session


At his sixth State of the State address Tuesday, Gov. Jay Nixon renewed his push to expand Medicaid, the health insurance program for the low-income population, in Missouri. He was careful, though, not to mention the “e” word itself. Instead, the governor called lawmakers to work on reforming the program.

“I look forward to working with all of you to bring affordable health coverage to working families in Missouri, and reform Medicaid the Missouri way,” said Nixon.

Signed into law by President Barack Obama in 2010, the Affordable Care Act asked states to increase Medicaid eligibility levels to cover more of the low-income population. A Supreme Court decision made it optional for states to do so.

“At this time last year, the same Medicaid debate was taking place in state Capitols across the country,” Nixon said. “Since that time, we’ve seen governors and legislators, Republicans and Democrats, in other states come together to reform their health care system. But here in Missouri, we stood still.”

Missouri’s Medicaid program, MO HealthNet, doesn’t cover any able-bodied adults with no children, no matter how low their income. If expanded to the level called for by Nixon and the federal law, the program would cover low-income individuals and families making up to 138 percent of the federal poverty level, which is about $30,000 annually for a family of four.

But it seems like Nixon got the Republican-led legislature’s message: without talk of reform, lawmakers won’t touch the Medicaid issue.

missouri house floor
Credit File Photo / KBIA News
The Missouri House floor

While a guest at KBIA’s live talk show Intersection, House Speaker Tim Jones (R-Eureka) told host Ryan Famuliner that outright Medicaid expansion simply won’t happen in Missouri.

“It’s a complete nonstarter for our state Senate,” Jones said.”You’d bring a lot more people to the table if you talk about reform.”

Jones and many other Republican state lawmakers have called Medicaid a “broken system,” citing instances of payment fraud and studies that say Medicaid enrollees aren’t in much better health than the uninsured population.

Last year, Missouri’s Republican-led legislature smashed repeated attempts by Democratic lawmakers to expand the program as called for by the federal law. GOP proposals to reform the program, which included reducing the eligibility levels for children and pregnant women, never made it past committee hearings.

Democratic Representative Chris Kelly has filed a bill that would expand Medicaid as called for by the Affordable Care Act. GOP lawmakers are expected to file bills that would feature reforms to the existing program. Over the session interim, Republican Representative Jay Barnes put together a fiscal analysis that includes lots of reform to Missouri’s Medicaid, saving money for the state, while also covering more low-income people.

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