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Barnes: Mo. Senate unwilling to take up Medicaid expansion alternative

Governor Jay Nixon announces support for expansion of Medicaid

Missouri governor Jay Nixon announces his support for the expansion of Medicaid in Missouri during a press conference on Thursday, Nov. 29, 2012, at the BJC Center for Outpatient Health in St. Louis. Photo by Chris Lee, clee@post-dispatch.com

JEFFERSON CITY • The Missouri House signaled on Wednesday an end to this session’s Medicaid expansion battle, blaming the Senate for its unwillingness to explore an alternative proposal backed by some House Republicans.

“Unfortunately, the Missouri state Senate has indicated it does not have the stomach to pick up a Medicaid transformation bill this year,” said Rep. Jay Barnes, R-Jefferson City, after proposing and then withdrawing an amendment containing his alternative proposal on the House floor. “Rather than figure out how we can make the best out of a bad situation, they are ceding the field for another year.”

Meanwhile, House Minority Leader Jake Hummel, D-St. Louis, issued a strongly worded statement putting the issue back on House Republicans. He deemed the entire session “a total and abject failure” — with three weeks until its end.

“Expanding Medicaid was the single most important issue facing the General Assembly this year, and House Republicans simply decided to give up,” Hummel said. “In doing so, House Republicans abandoned struggling rural hospitals; they abandoned 24,000 new jobs; and they abandoned billions of federal dollars paid by Missouri taxpayers that should have been brought back to Missouri.”

The debate over whether Missouri should expand its health care program for the poor through the federal Affordable Care Act has been one of the dominant topics of the session.

Gov. Jay Nixon, a Democrat, has spent several weeks traveling the state to build support for Medicaid expansion, and he has deemed it his No. 1 legislative priority. Last week, Nixon led a rally of more than 1,000 expansion supporters at the Capitol. Those backing expansion include business, labor, law enforcement and health care advocacy groups.

Republicans, who control both the House and Senate, have repeatedly refused full-scale expansion proposals .

But Barnes moved forward with his reform-based alternative, which would expand eligibility for some Missourians but wouldn’t go as far as the federal health care law calls for and would require several waivers from the federal government.

“We have a tremendous opportunity,” Barnes said of his proposal. “We can remake Missouri Medicaid into the most market-based system in the country — in the entire history of the federal Medicaid program.”

Republicans have long argued that Medicaid is plagued with fraud, waste and abuse. Barnes had included provisions in his plan to address those issues .

In recent weeks, Nixon also has been mentioning the potential for reform through expansion, and he dubbed Barnes’ proposal as the most likely vehicle to get expansion through and bring billions of federal dollars to the state to provide health care for the uninsured.

Nixon’s office didn’t immediately respond to a Post-Dispatch request for comment on Barnes’ decision to drop his effort Wednesday.



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The chamber gave first-round approval to a nearly $25 billion budget plan after about six hours of debate Tuesday that largely centered on Democrats’ plans to add nearly $900 million in federal dollars to get an estimated 200,000 more people on Missouri’s Medicaid rolls.

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