Jay Nixon, Missouri's Democratic governor, will press the Republican-controlled state legislature to adopt an expansion of Medicaid that would provide health care coverage to 300,000 of the state's poor residents, he announced Thursday.
President Barack Obama's health care reform law seeks to provide Medicaid benefits, starting in 2014, to as many as 17 million people who earn up to 133 percent of the federal poverty level, which is $14,856 this year. But when the Supreme Court upheld the rest of Obamacare in June, it ruled states could opt out and allow those poor residents to remain uninsured. So far, eight Republican governors, including Rick Perry of Texas and Bobby Jindal of Louisiana, have declared their states won't expand Medicaid.
"The budget I plan to submit to the legislature for fiscal year 2014 will include federal funding to provide health care for an estimated additional 300,000 Missourians -- men, women and children -- who currently have no health insurance. It's the smart thing to do and it's the right thing to do," Nixon said during a press conference at a Kansas City hospital, according to a news release.
Under the health care reform law, the federal government will pay the full cost of enrolling the people newly eligible for Medicaid from 2014 to 2016, then gradually will scale down its share until it reaches 90 percent in 2022 and later years. If every state joined the Medicaid expansion, state spending on the program would rise 3 percent overall, while more than 20 million people would gain health coverage, according to a report issued this week by the Urban Institute and the Henry J. Kaiser Family Foundation.
Nixon, however, is likely to encounter resistance from Missouri's Republican-dominated legislature, the St. Louis Post-Dispatch reported. Maine Gov. Paul LePage (R), an opponent of the Medicaid expansion, is expected to face a similar problem with the Democratically controlled legislature in his state next year.
In addition to states' decisions to add people to their Medicaid rolls or not, governors and legislatures are wrestling with whether to create health insurance exchanges under the health care reform law. These online marketplaces for health insurance will be the gateway to coverage and financial assistance for millions of uninsured people starting in 2014. The law calls for states to manage their own exchanges, but so far, 17 states have notified federal officials they will leave the task to the Obama administration. Arizona Gov. Jan Brewer (R) on Wednesday became the most recent state chief executive to bow out.
CORRECTION: This article has been edited to say that eight governors have rejected an expansion of Medicaid in their states. A previous version said nine governors had done so.