The St. Louis-based Missouri Foundation For Health gives away about $60 million a year to nonprofit groups that provide medical care to the poor and uninsured. The foundation has paid for kids’ dental care; provided the cervical cancer vaccine to young women who couldn’t otherwise afford it and promoted anti-smoking programs around the state.
Now it’s getting heat for a $51 million a year grant it didn’t award — one requested by Gov. Matt Blunt. Missouri’s chief executive oversees the state’s $22.5 billion budget, and he wanted foundation money to help pay for some of the state’s underfunded health care programs.
The foundation replied, correctly, that those programs are the state’s responsibility. The rejection triggered threats from Mr. Blunt to the foundation’s board. The latest came in a letter dated May 27 that lays claim to the foundation’s money as “taxpayer assets.”
The letter was sent on the same day that the foundation unveiled a new website, covermissouri.org, focusing on the 772,000 Missouri residents who have no health insurance. Among them are more than 100,000 who lost coverage as a result of Medicaid cuts pushed by Mr. Blunt.

That timing is purely coincidental, said Rich Chrismer, a spokesman for the governor. He said Mr. Blunt acted because “the foundation was in a good position to partner with the state as part of a substantial collaboration” to reduce the number of uninsured people and improve the health care system.
Republicans have been trying to wrest control of the foundation and its $1.3 billion endowment since shortly after Mr. Blunt came to office. In 2006, then-Rep. Nathan Cooper, R-Cape Girardeau, sponsored a bill to abolish the foundation’s community advisory committee and give control of its board of directors to the governor. The bill later was withdrawn.
The state Republican Party paid for radio ads this year that criticized the foundation for its ties to Attorney General Jay Nixon, the presumptive Democratic candidate for governor.
Mr. Blunt continued that theme this week, describing the foundation as “controlled by Attorney General Jay Nixon.” In fact, Mr. Nixon names members of the community advisory board. That group selects the board of directors.
The foundation was formed in 2000 to settle a suit Mr. Nixon brought against Blue Cross Blue Shield of Missouri. Blue Cross, a nonprofit, had created a for-profit insurance company called Right Choice. Mr. Nixon maintained that by doing so, it illegally transferred some of the nonprofit’s assets to the profit-making subsidiary.

In February, after the foundation spurned his $51 million grant request, Mr. Blunt wrote a letter to the foundation’s board arguing that the foundation’s assets “would not be available without the favorable tax treatment afforded to nonprofit organizations in Missouri.”
He said “a strong argument can be made that those assets rightfully belong to Missouri taxpayers.”
That argument would seem to allow the governor to lay claim to money held by other nonprofit groups, which include most of Missouri’s hospitals and charities. Like the foundation, they pay no income, sales or property taxes.
For example, BJC Healthcare, the region’s largest hospital system, made $226 million more than it spent in 2005. It has a funds balance — think of it like a university’s endowment — of $2.25 billion. If those assets — in the governor’s words — “would not be available without the favorable tax treatment afforded to nonprofit organizations in Missouri,” perhaps Mr. Blunt will lay claim to them as well.
Mr. Blunt’s spokesman said the governor has no intention of seeking assets from other nonprofits. Then he has no business trying to bully the foundation into surrendering its assets, either.
With its funding for health policy studies and direct support for medical programs, the foundation has made a substantial contribution to improving health care in our state. It has committed $9.2 million to various state agencies for health-related projects over the next few years.
What it refuses to do is allow its money to supplant tax dollars. Much as Mr. Blunt might wish otherwise, health care remains a state obligation.