Opening Medicaid to 300,000 more Missourians would bring $5.7 billion in federal funds to the state government over the next three years, Gov. Jay Nixon said in Rolla Friday afternoon.
"Will we bring the tax dollars we send to Washington back home to Missouri?" Nixon asked. House Republicans have voted not to participate in the Medicaid expansion called for in the Affordable Care Act, known as Obamacare.
Nixon said if Missouri does not participate in the expansion plan, "other states get the benefits, we get the bill."
Speaking at the Technology Development Center at Missouri University of Science and Technology's Innovation Park next to the Miner Golf Course and across the street from the Phelps County Regional Medical Center, Nixon was joined by law enforcement officers from throughout the Rolla area.
He referred to them at one point in his speech, noting that the Missouri Department of Mental Health has reported turning down the federal dollars available for the Medicaid expansion "will limit acess to mental health services and weaken public safety."
The law enforcement officers, he said, will find more mentally unstable individuals on the streets, which he said will mean "more dangerous people out there, challenged and needing help."
The governor repeated themes he has stressed in speeches throughout the state:
The expansion will be "at no cost to the state."
Non-partisan business groups throughout the state, including the Missouri Chamber of Commerce, support this plan." Chambers of commerce in Boliver, Branson, Cape Girardeau, Columbia, Sedalia, Springfield, St. Louis, West Plains and other cities also support the expansion.
"Last fall, a study by the University of Missouri found that bringing these dollars back to Missouri to strengthen Medicaid would create 24,000 new jobs in Missouri in 2014 alone."
"Low-income Missorians who can't afford health insurance and earn less than 138 percent of the Federal Poverty Level – or $32,500 a year for a famiy of four – would be eligible for coverage."
"Republican governors in Arizona, Florida, Michigan, Nevada, New Jersey, New Mexico, North Dakota and Ohio are putting partisan politics aside and embraching this opportunity to strengthen Medicaid and create jobs in their states."
John Denbo, CEO of PCRMC, introduced the governor at the meeting attended by people from local governments, the business community, the hospital, city and county government and agencies that serve people in poverty.
"There could not be a more critical issue," Denbo said.
Gov. Nixon spoke about a related issue that Denbo had explained at the hospital board meeting last week, the effect on DSH payments to the hospitals. Pronounced "dish payments," these payments are made by the federal government to hospitals found to be "disproportionate share hospitals," i.e. hospitals that have a higher-than-average number of patients who can't pay for services.
These DSH hospitals are primarily in rural areas. PCRMC and Salem Memorial District Hospital receive those payments and rely on them. The DSH grants will end when Obamacare takes full effect, because the law assumes Medicaid expansion will cover patients, so there will be no need for the DSH payments.
The act did not take into account the possibility that the Supreme Court would allow states to opt out of the Medicaid expansion, which Missouri appears to be inclined to do.
Nixon said several times that Medicaid expansion is both"the smart thing to do and the right thing to do."
He also said that it is a business decision, not a political decision, for "Strengthening Medicaid will strengthen our economy."
The governor asked those who attended to take action by calling their legislators.
"I wouldn't be here if I didn't need your help," the governor said.
Republican House and Senate members oppose the Medicaid expansion for a number of reasons, foremost being the $16 trillion federal debt already on the books that will grow with the Medicaid expansion.
Related to that, the GOP is concerned that because of the expense, the federal government will change it in midstream by cutting or closing programs, leaving the state on the hook to pay for the expanded services.
Shortly before the governor took the podium to speak in Rolla about the federal payments for Medicaid expansion, the Obama administration announced that the White House would be closed to tourists effective Saturday until further notice "due to staffing cuts resulting from sequestration."