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House exploring Medicaid fixes during interim

By Collin Reischman

JEFFERSON CITY, Mo. — As the state continues to struggle with the politically and financially challenging task of whether to expand Medicaid eligibility as mandated by the Affordable Care Act, House Speaker Tim Jones, R-Eureka, is continuing to demand work on the subject in the interim.

Click to enlarge the list. The full list with where the citizens work is in the Rolling Interim Committee list as well.
Click to enlarge the list. The full list with where the citizens work is in the Rolling Interim Committee list as well.

Jones named two bodies last week that will work during the interim on the subject for the House, as well as assigning members to a joint committee with the Senate. The committee, House Interim Committee on Medicaid Transformation announced its full roster Monday, and the Committee will be chaired by Rep. Jay Barnes, R-Jefferson City. Barnes’ Government Accountability and Oversight committee heard Medicaid expansion legislation offered by Democrats in the House this year, and has been a “true leader,” on the Medicaid issue, according to Jones.

But it is the commission chaired by Rep. Noel Torpey, R-Independence, which will be doing much of the work right away. Torpey’s commission, the “Citizens and Legislators Working Group on Medicaid Eligibility and Reform,” will conduct public meetings throughout the state and will consist largely of citizens from across Missouri from a wide range of backgrounds.

“Hopefully we can locate a good balance of healthcare professionals, faith-based professionals and business men and women to give us a wide range of input on this issue,” Torpey told The Missouri Times.

Torpey said his commission will have much of the summer to hear informational testimony during public meetings and the end product will be a report Torpey submits to Barnes’ committee suggesting possible solutions and courses of action.

As Democrats across the state call for Medicaid expansion in the name of both smart business and compassionate public policy, Republicans have repeatedly shied away from discussion of expanding what they call a “broken system,” of providing health care coverage, and Torpey and Barnes are both unlikely to offer any expansion options without subsequent reforms to the program itself.

“What we need to search for is, what is the best thing for Missouri that will provide our citizens with healthcare and do it the most efficiently and most effectively,” Torpey said. “There is a lot of feedback to get and a lot of considerations to be had, and we aren’t going to try to predict the outcome of that, I’m trying not to come at this with any preconceived notions.”

Expansion Supporters Optimistic

While Jones has repeatedly stated that he will not implement “any form of Obamacare,” as his fellow House Republicans continue to call on significant reforms to the program before expansion, statewide activists groups favoring the expansion see the formation of the new bodies as a reason to be optimistic. Jen Bersdale, the Executive Director of Missouri health Care for All, said she knows of several members of the Medicaid Coalition applying to be members of the citizen commission.

“We know from conversations we’ve had with Jones’ office that he will be making sure there are some people on the commission that are opposed to Obamacare,” Bersdale told The Missouri Times. “But we also know a lot of people in favor of expansion are trying to get on, and as long as people don’t come with the mission of killing the expansion, we believe there’s still a very good chance that this will ultimately help, not hurt, the cause.”

Bersdale said public meetings would likely increase support for expansion and her group contends that the majority of Missouri citizens would prefer to expand Medicaid, regardless of the political implications.

Sean Nicholson, Executive Director of Progress Missouri, a left-leaning activist organization supporting Medicaid Expansion, said regardless of the makeup of the citizen commission, he felt the public meetings they will hold will be extremely effective at swaying opinions.

“Just since January in hearing after hearing in the Capitol, people came out in broad support of this expansion,” Nicholson told The Missouri Times. “We fully expect that to happen again and we fully expect some of the calls for expansion to come from traditionally conservative groups or individuals. That alone should be very telling that this is the right thing to do for the state.”

Nicholson was referring to groups like the statewide Chamber of Commerce and the Missouri Hospital Association. The Chamber — which endorsed Mitt Romney for President during the 2012 election — has come out in support of the expansion despite having publicly criticized the ACA as a whole. The Missouri Hospital Association and the Missouri Healthcare Association, both traditionally right-leaning statewide healthcare providers, have endorsed the expansion of Medicaid.

Jones has said Missourians do not support any form of Obamacare and points to ballot measures on individual mandates and state-established insurance exchanges —both of which are elements of the ACA that were roundly voted down by Missourians — as a sign that the state does not support expansion. Jones said he will be “very wary,” of anything that could be construed as “implementing Obamacare.”

Nicholson said Jones misrepresented the nature of those two measures and, despite the Speaker’s rhetoric, he views the formation of the committees as a step toward expansion and the “acceptance of reality,” from Jones.

“I think, first of all, that he’s seriously misrepresenting what those ballot measures were about,” Nicholson said. “First, neither of them had anything at all to do with Medicaid expansion. And even if they did, the Affordable Care Act is the law of the land. The Supreme Court upheld it and the American people re-elected the President. More and more Republican governors and lawmakers are beginning to see this as the smart thing to do and the right thing to do and it’s quickly becoming the law in conservative states. I think [Jones] understands that and [Progress Missouri] sees any further discussion with the public about expansion as a clear step in the right direction.”