Top Republican urges legislators to pass Medicaid expansion

By Phill Brooks

JEFFERSON CITY — A major leader in the creation of the modern Missouri Republican Party came before a state business group to promote a measure that already has been rejected by GOP state lawmakers — Medicaid expansion.

Kit Bond spoke to a conference of the Missouri Chamber of Commerce, an organization that has retained the former U.S. senator and former governor to lobby for expansion.

Bond, a former Missouri governor and U.S. senator, repeated his opposition to the underlying federal health care law, but warned that the law includes cuts in federal medical payments that will harm Missouri health providers without the extra funds from Medicaid expansion.

“If Missouri doesn’t act to address these coming cuts, I’m concerned that hospitals in rural and inner communities will be forced to make dramatic cuts in their services and, in some cases, close their doors,” Bond said.

But Bond’s endorsement for Medicaid expansion has not won over two of the harshest Republican critics in the Missouri Senate.

“Other than being a mild curiosity, I don’t know that it really adds much to it,” said Senate Appropriations Committee Chairman Kurt Schaefer, R-Columbia. “I understand he has a position that he’s advocating for, but I don’t know if that’s going to change anybody’s mind.”

The Senate’s only physician, Sen. Rob Schaaf, R-St. Joseph, said he was in more agreement when Bond had voiced opposition to the entire federal health care law.

Bond, however, argued to the business group that Medicaid expansion could be used as a vehicle for major changes that Republicans have sought in the system.

“A Missouri solution designed with true market principles can reward the values of hard work, self sufficiency and personal responsibility; not punishment, which the current system too often does,” Bond said.

Bond cited various ideas that have been proposed in the Legislature, including health savings accounts by which recipients would have a choice in how to spend limited health care funds and extra charges for services like emergency rooms that were used inappropriately.

But Schaafer said some of these changes would require changes in federal law and beyond what Missouri has the power to require in its Medicaid program.

Bond said he has been talking with individual Missouri Republican legislators, but he acknowledged that there are not yet sufficient votes for passage.

“Do we have all the votes now? No, but we’ve got a significant number who are working on the process, and I can tell you that there are enough of them engaged in the process right now that there will be, as the session develops, a significant group coming forward.”

Earlier this year, a Medicaid expansion effort was defeated in the Senate without a single Republican vote in support. Last year, a similar effort failed in the House with only one Republican vote in support against more than 100 against expansion.