The Missouri legislature is cutting off the state’s fiscal nose to save face. The House has passed a budget that does not include Medicaid expansion, a politically popular but fiscally foolish decision.
Republicans in Jefferson City are exhibiting their displeasure with Obamacare by refusing to expand the state Medicaid program, thus opting out of billions of our tax dollars that would have returned to Missouri to fund the expansion.
The capitol refusniks are using the opt-out to show their displeasure with the national plan, reflecting their voting base while ignoring reality. Obamacare is not going away. All the raging against the program in the world will not overcome the fact that it has been voted in and certified by the Supreme Court. That’s the world we live in. Now it is up to our legislators to stop throwing tantrums and find a responsible way to adjust to reality.
The Missouri Chamber of Commerce, not a terribly radical group, has said as much. Chamber president Dan Mehan makes the point that the money we are refusing from Washington will have to be made up by purchasers of commercial insurance - employers across the state. That means everyone’s premiums will rise. It is also worth considering what will happen to the cost of health care in the state as Washington phases out payments to hospitals that cover the bills of the uninsured. Do not imagine that those costs will not be passed along to health-care consumers.
By refusing to expand Medicaid, state legislators will have made a point but we will pay for it.
Obamacare is not popular in Missouri, thus all fruit of that tree is deemed poisonous. Those who oppose Medicaid expansion to cover 300,000 additional uninsured Missourians point to the uncertain future of federal funding. While federal funds are supposed to pay for expansion the first three years and never less than 90 percent of the cost thereafter, legislators remain leery.
Legislators’ fear that in the future the state will be left holding the Medicaid financial bag are not unreasonable. History shows that the unfunded mandate is the bane of state budgets nationwide. However, refusing to address the underlying problem and confusing political posturing for action will have the same bad result in this case.
The options for Missouri legislators are these: opt out, pay now; opt in, pay later; or - and this is radical thinking - get off the ideological bandwagon and do something for Missourians that addresses the problem without breaking the bank.
Taking a stand that will cost Missourians real dollars every month in higher insurance fees and rising medical costs is not leadership. We need legislators who will actually earn what we pay them and figure out a solution.
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