Another Republican governor announces support for Medicaid expansion

“Expanding access to Medicaid services for three years is a compassionate, common-sense step forward … it is not a white flag of surrender to government-run healthcare," Scott told reporters today.

Missouri Gov. Jay Nixon, a Democrat, has been promoting the expansion proposal in appearances across the state in recent weeks. Today, he was in St. Charles and West Plains, touting the potential economic benefits of expansion.

Nixon has often noted the shift toward support for Medicaid expansion in other states – particularly those controlled by Republicans.

"Across the country, Republican governors in Ohio, Michigan, Arizona, North Dakota, New Mexico and Nevada are putting politics aside to seize this opportunity to create jobs and stand up for taxpayers in their states," Nixon said in a news release on his St. Charles trip today. "We must do the same here in Missouri."

Under the ACA proposal, Medicaid eligibility would be expanded to cover nearly 300,000 more Missourians at no cost to the state for the first three years. The federal government would continue to pick up most of the tab for new recipients beyond that.

Nixon made the Medicaid expansion plan a central piece of his budget proposal for the fiscal year that begins July 1, but GOP leaders in the House and Senate have said the state is unlikely to expand the health care program for the poor.

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

The governor’s budget office also estimates that 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.

In his remarks today, Scott said the plan he’s backing would be a three-year expansion of Florida’s Medicaid program, as long as the federal government meets its commitment to pay 100 percent of the cost.

“Legislation we would support would sunset after three years and need to be reauthorized,” he said, according to prepared remarks available from his office. “It would also sunset if the federal government backed away from their 100 percent commitment during this period.”

Ohio’s Republican Gov. John Kasich announced earlier this month that he also will push for the expansion, following a similar announcement from Arizona Gov. Jan Brewer last month.

Missouri House Republicans have spent much of the first month of the legislative session vaguely discussing “Medicaid transformation.” It’s still unclear what such proposals will look like, but most seem to agree that it would attempt to curb waste and other inefficiencies in the program. Some have suggested the state could turn to copays or other measures to keep costs low and put some responsibility on recipients.

During a hearing today on a proposed resolution that would serve as the Legislature’s request to Congress to continue Disproportionate Share Hospital payments to states that don’t expand Medicaid, “transformation” was again discussed without specifics. Lawmakers said the loss of DSH payments could threaten Missouri hospitals that treat the uninsured.

“We’re not going to expand Medicaid at this point,” said Rep. Lynn Morris, R-Nixa.