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Gov. Nixon visits Farmington to push for Medicaid expansion

FARMINGTON – Speaking before a crowd at Parkland Health Center in Farmington, Gov. Jay Nixon warned that the tab for the General Assembly’s inaction on Medicaid expansion in the state is now exceeding $550 million.

Standing behind Nixon at the podium were a number of health care providers and business leaders who are joining him in encouraging Missourians to call on their legislators to put a stop to what he described as “further damage to the economy and the flow of taxpayer dollars to other states.”

Nixon offered his audience statistics he believes shows the negative effect this has already had on state unemployment figures.

“A recent report from the Missouri Chamber of Commerce and the Missouri Hospital Association found that inaction on Medicaid already cost the state more than 3,000 jobs over the past six months alone,” said Nixon.

“Since the first of this year, Missouri taxpayers have spent more than $550 million and counting to provide health care in other states — and where our tax dollars have gone, jobs have followed,” Nixon continued. “By denying Missourians any of the benefits but sticking them with the entire bill, the General Assembly is delivering Missouri families and businesses a one-two punch.

“That’s why, all across the state, we’re seeing doctors, nurses, business groups, first responders and faith leaders, speak out about the need to strengthen and reform Medicaid this year. With a little more than a month left in the legislative session, I urge the General Assembly to take action necessary to prevent further damage to our economy and bring Missourians’ tax dollars home.”

Nixon contends that Medicaid reform and expansion in the state will bring federal dollars that Missourians send to Washington — $2 billion a year — back to the state to provide health care coverage to 300,000 working Missourians making no more than $32,913 a year for a family of four.

“As a result of the legislature’s failure to act, those dollars — $5.47 million a day — are now being spent in other states,” Nixon declared. “A majority of states, including Missouri’s neighboring states of Arkansas, Kentucky, Illinois and Iowa, are moving forward with plans to expand and reform Medicaid.

“Under the Affordable Care Act, Medicaid expansion was also designed to compensate for payment cuts to hospitals and health care providers,” he continued. “Even though Missouri did not expand Medicaid, many of those payment cuts are still taking effect, forcing many hospitals, including Parkland Health Center, to reduce staff and services. According to the survey by the Missouri Chamber and MHA, ‘more than one-third of layoffs and one half of hiring freezes have been in rural areas where the need for health care workers is great and hospital jobs help support the economy.'”

The governor then noted that the Farmington Regional Chamber of Commerce passed a resolution Thursday in support of Medicaid expansion.

Farmington Chamber President/CEO Doug McDermott explained that the chamber’s resolution favoring Medicaid expansion in the state “was not carte blanche, but rather came with important recommendations and conditions.”

The resolution states, “The Farmington Regional Chamber of Commerce Board of Directors is supporting Medicaid Expansion, because this program is economically beneficial to our medical industry (increasing reimbursement rates while decreasing obligations to the private insurance sector), employers, the working poor, and brings Missouri tax dollars back to our state. We recognize there are concerns related to the expansion and for that reason our support comes with strong recommendations.

“They include: 

• Preserving Missouri’s AAA Bond Rating is critical;

• New recipients in the expansion must sign an acknowledgement that Missouri can only guarantee these new benefits for the limited remaining period of time that federal dollars are paying for them and after that the program is subject to budget approval and would be the first item cut if there aren’t enough dollars for education and other constitutionally guaranteed state obligations; and 

• Missouri participates subject to the federal government keeping its promise to pay 100 percent for the limited period of time; and Missouri elected officials will use this time frame to examine the system to work on modifications and improvements that will lead to delivery of benefits to those most in need and at an affordable price to the state.”

Introducing Nixon at the podium was Tom Karl, Parkland Health Center president.

“Parkland Health Center is committed to providing good jobs and quality services to this community, but just like other hospitals across the state, the combination of declining federal payments and the failure to cover more Missouri citizens through Medicaid is putting us in a pinch,” he said. “Reforming Medicaid and adding coverage to the working poor is absolutely vital to the physical and economic health of this community, so we will continue to communicate with our representatives and senators about the importance of moving forward this year.”

Mineral Area Regional Medical Center CEO Lynn Mergen was also blunt about the negative effects the state is experiencing because Medicaid expansion has not come to Missouri.

“Here in Farmington, we see the consequences of Missourians trapped in the coverage gap each and every day,” he said. “We appreciate the complexities associated with expanding Medicaid. However most hospitals, especially those in rural areas, are experiencing real financial pressures and we need the General Assembly to take action. Our patients and families deserve to know when they need us, we will be there to provide great care.”

Nixon stated that, according to an analysis by the Missouri Economic Research and Information Center (MERIC), expanding and reforming Medicaid would result in the creation of 23,868 jobs, $9.9 billion in new wages and $14.6 billion in new Gross State Product (GSP) from 2015 to 2022.

According to the report, Medicaid expansion would also generate $402 million in new state general revenue from 2015 to 2022, including $53 million in new general revenue in 2015 alone.

Following Nixon’s speech, state Rep. Kevin Engler, R-Farmington, said he, Rep. Linda Black, D-Desloge, and Republican State Sen. Gary Romine — who chairs a interim committee on Medicaid in the Senate — had already expressed their desire to work with the governor on Medicaid expansion, but not before some changes in the Medicaid program itself are made.

“As the governor was speaking I’m sure down the hall there were a bunch of people on Medicaid sitting in the emergency room using the highest medical care possible because they had no deductibles, no co-payments, no skin in the game whatsoever,” Engler. “So, they’re in there doing that and we don’t want to reform it? Did you hear him talk about reform? No. We’ve got to reform it before we add 300,000 rather than admitting that maybe it needs to be reformed. But that’s OK, before we reform it, we’ll just add 300,000 people.

“The other thing I thought was interesting was that of all the places in the state the governor could have gone to, he came to the place where the state senator is the one carrying the bill trying to do what needs to get done,” he continued. “And the bulk of the others of us have expressed a desire to go ahead and get it done. You spend $10,000 to come in on an airplane, why didn’t he go down to Joplin or to West Plains or one of these places where their representatives and senators are diametrically opposed to expansion?”

“As a result of the legislature’s failure to act, those dollars, $5.47 million a day, are now being spent in other states.” — Gov. Jay Nixon

Gov. Jay Nixon visited Parkland Health Center in Farmington Friday to extol the economic benefits of Medicaid expansion to the state and the negative fallout if the Missouri Legislature refuses to act. In response, Rep. Kevin Engler, R-Farmington, said Medicaid reform has to take place before 300,000 more Missourians are added to the rolls.

Gov. Jay Nixon visited Parkland Health Center in Farmington Friday to extol the economic benefits of Medicaid expansion to the state and the negative fallout if the Missouri Legislature refuses to act. In response, Rep. Kevin Engler, R-Farmington, said Medicaid reform has to take place before 300,000 more Missourians are added to the rolls.

Kevin Jenkins is a reporter for the Daily Journal and can be reached at 573-518-3614 or

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