Nixon Wants to “Reward Work” As Part of Medicaid Reform

Mar 11, 2015

Gov. Nixon speaking at the Missouri Career Center in Springfield on Wednesday. Behind, from left: Jim Anderson, vice president of Marketing and Public Affairs at CoxHealth; Matt Morrow, president of the Springfield Area Chamber of Commerce; and Dr. Alan Scarrow, president of Mercy Hospital and Mercy Clinic in Springfield.
Credit Scott Harvey / KSMU

As the debate to expand Medicaid in Missouri continues to make little progress, Gov. Jay Nixon says he’ll consider proposals to reform the system.

Speaking Wednesday at the Missouri Career Center in Springfield, Nixon outlined reforms based upon four principals, including a requirement that recipients must work.

"Anyone who refuses to work, or actively look for work, should have higher premiums; and if they don’t pay those premiums, they could lose their health care coverage," Nixon said.

He pointed to states like Arkansas and Iowa where participants are required to contribute to health care through co-pays and cost-sharing, and says those who have jobs or are actively searching for one would have their monthly premiums reduced. 

He says reforms would also need to protect taxpayers, help small businesses, and promote personal responsibility.

Nixon says so far the General Assembly has yet to push forward a strong bill on reform, adding that as other states make such efforts - including ones led by Republican governors or legislatures – so should Missouri.

“It’s much different than it was a year ago. States that nobody thought were gonna move forward have moved forward. The federal government has granted significant opportunities for folks to use each of the states for laboratories of democracy and has granted wide range of opportunities.”

Matt Morrow is president of the Springfield Area Chamber of Commerce. He says while a failure to act earlier on Medicaid has come at a cost to the state, there’s now more proof of how reforms are working elsewhere.

“So we have a chance now to actually see what is working and what isn’t working in some of the other states there in terms of reform, tie that to Medicaid expansion, and I think we may all be winners out of all of that,” Morrow said.

Nixon adds that passing these reforms will require expanding Medicaid eligibility up to 138 percent of the federal poverty level, which equates to $27,000 a year for a family of three.

The deadline to file any new legislation in both the House and Senate this session has passed. Lawmakers can add new language to existing bills in the form of amendments.

According to Nixon, as of February, 28 states and the District of Columbia including Missouri’s neighboring states of Iowa, Illinois, Kentucky and Arkansas have strengthened and reformed Medicaid. 

The governor has called on expanding Medicaid to nearly 300,000 Missourians over the past few years. But the Republican-led legislature has cited concerns over the program’s long-terms costs. On Tuesday, an amendment to a House budget bill to expand Medicaid eligibility was rejected on a party line vote.