Missouri House committee rejects Medicaid expansion bill

In rebuffing the proposal, Republican House leaders said they would rather focus on Medicaid “transformation” — an overhaul of the health care program to weed out inefficiencies.

Rep. Jay Barnes, R-Jefferson City, is expected to file a Medicaid bill today that will give a clearer picture of their plan moving forward.

After more than an hour and a half of testimony, the House Government Oversight and Accountability Committee voted 5-2 against the Democrats’ bill, which would have expanded Medicaid eligibility to thousands of Missourians under an optional provision of the federal Affordable Care Act.

Several representatives from health care and business advocacy groups spoke in favor of expansion during the hearing. One person spoke against it. Supporters say expansion will help create jobs in Missouri, provide health care for the poor and keep rural hospitals that will lose other federal dollars afloat.

“This should not be an argument over our president or the Affordable Care Act,” said House Minority Leader Jake Hummel, D-St. Louis, who sponsored the expansion bill.

“We’re talking about access to health care for thousands of people and job creation.”

The federal government would cover the costs of new Medicaid recipients in the first three years and continue paying most of the tab beyond that.

House Speaker Tim Jones, R-Eureka, told reporters Monday that the House “transformation” plan will focus on providing health care to seniors, children and the disabled, while providing savings to the state.

“I look at this as — at a minimum — a two-year project,” Jones said. “We’re just at the very beginning of it.”

Hummel said he has not seen the GOP proposal and couldn’t speak directly on it but he would be willing to look at proposed efficiencies.

The federal government already pays part of Missouri’s Medicaid costs. Nixon’s budget proposal for the fiscal year that begins July 1 calls for $907.5 million in federal spending for the influx of an estimated 260,000 new Medicaid enrollees.

The governor’s budget office estimates the state would see a $300 million boost to its general revenue fund over the next three years if the Legislature expands Medicaid.

Once the state’s costs kick in, savings from other programs and estimated new revenue would more than cover the cost of the expansion, according to the estimates.

The expansion bill’s defeat in committee Monday means the Democrats’ proposal in the House is effectively dead.

“We wanted to let everybody know — once and for all — that has been our position and will continue to be our position this year,” Jones said. “We want to talk about constructive ways to look at our Medicaid system.”

Several House Republicans have expressed concern over the expansion’s cost to the federal government, the state’s future expenses and an overall skepticism of the federal health care law.

“I want to help people that are unable to help themselves. I don’t think we should pay for people who are unwilling to help themselves,” said Rep. Mark Parkinson, R-St. Charles. “That’s a big difference.”

The House social services appropriations committee also rejected an attempt to include the expansion in its budget proposal on Monday.

“We can’t afford it,” said committee chair Sue Allen, R-Town and Country.