Gov. doubts Medicaid expansion savings

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Gov. doubts Medicaid expansion savings

Fri, 02/21/2020 - 07:29
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He says studies do little to influence his opinion, as opposing studies could be found

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JEFFERSON CITY – Expanding Missouri Medicaid is a possibility.

There is no nothing new in that. The idea has been around for years. But a petition drive is in progress to put the issue on the ballot.

Lots of groups – last week the list grew to include the Kansas City Chamber of Commerce – support the ballot initiative.

Gov. Mike Parson is not on the list of supporters.

The call for Missouri Medicaid expansion started immediately after former Gov. Matt Blunt cut tens of thousands of Missourians from the progam in 2005 “to save money.” But lots of tax cuts for businesses followed – including for the General Moters plant in Wentzville – which does not suggest one led to the other, only that state leaders who claim they need to save tax dollars appear at odds with fiscal logic when giving away tax dollars.

The GOP-dominated General Assembly continues to say no to Medicaid expansion.

Facts, figures and data are needed when discussing Medicaid expansion, Parson said after a luncheon at the Governor’s Mansion.

“We can all go out there and do a study,” he said. “There’s different sources you can get data (from) if you want to be on one side. … If you’re on the other side, somebody’s going to give you data.”

House Minority Floor Leader Crystal Quade said later that suggesting all studies have equal merit is without merit: a “false equivalency.”

“It is ridiculous. (Seven) rural hospitals have closed. We have folks driving hours to find health care,” she said in answer to a Reddit Ask Me Anything question from this newspaper. “Expansion will cover hundreds of thousands of additional people, will provide hundreds of thousands of jobs and will have a budgetary benefit to our state. To say that we can find studies for anything? Sounds like a copout for someone who has been proven wrong.”

Parson said implications of expansion are huge for Missouri.

A reporter asked for Parson’s data source on Medicaid, considering much research suggests the state would save money in the long run on health care costs by expanding Medicaid, which could mean more preventive checkups and less high-cost emergency room use.

“I’ll say years of experience,” Parson answered, relying on the premise that no government program has expanded and then cost less. “Every time a government program comes into existence, it normally will always expand and cost money. The Medicaid system you’re talking about, this year, without any expansion whatsoever, the cost to us was $200 million … more this year.”

Some states, he said, have expanded successfully, and some have not.

“I just think it’s going to cost us more money. I don’t care how you look at it, there’ll be more expense to be able to cover more people,” Parson said, maintaining that more Medicaid would take money from other state programs. “At some point, you’re going to have the data to say whether it works or whether it don’t … and I don’t know that we have that right now.

Rep. Jim Neely, a Republican and a physician whose House district includes Clay and Ray counties, showed interest in the government assisting people through Medicaid.

“Let’s take a look at Medicaid. We turned it over to private enterprise to take care of this. You know they’re going to make a profit on it. I thought it was the government’s job to take care of the folks that are on Medicaid,” Neely, a Republican primary candidate for governor, said in a Capitol building hall while waiting for a House hearing to start.

State Auditor Nicole Galloway, a Democrat, said she has heard the argument that Medicaid expansion would cost the state more money, but facts stand on the side of expansion.

“There have been multiple studies that have shown that Medicaid expansion will actually save money in the state’s budget,” Galloway said to members of the Missouri Press Association gathered in a Senate meeting room. “Other, more conservative-leaning states have experienced that exact outcome, where there has been budget savings in the expansion of Medicaid.”

The Center on Budget and Policy Priorities, Washington, looked at a group of studies focused on Medicaid expansion.

can all go out there and do a study. There’s different sources you can get data (from) if you want to be on one side. ... If you’re on the other side, sombody’s going to give

“With dozens of scientific analyses spanning multiple years, the best evidence we currently have suggests is that Medicaid expansion greatly improved access to care, generally improved quality of care, and to a lesser degree, positively affected people’s health,” according to Olena Mazurenko, the lead author of an analysis of peer-reviewed evidence on the impact of expansion.

A Georgetown University Health Institute Policy study offered further support for expansion.

“Michigan, Montana, Louisiana, Colorado and Virginia have all expanded Medicaid. In each of these states, local analysis has shown expanding Medicaid has either been a positive for the state’s general fund revenues or has not resulted in any additional cost to the state,” the study found. “The reason is a combination of substantial state savings from Medicaid, now largely paying for formerly state-covered health services, and additional revenues as a result of expansion from increased economic activity and hospital/health plan contributions.”

In addition to saving money for the state, more people would have health coverage, Galloway said.

“Nearly a quarter million working Missourians will be able to have access to health care,” she said. “Seven rural hospitals have closed in the last six years and so, even if you’re lucky enough to have health insurance, there’s nowhere to use it.”

Some Republicans have said Medicaid expansion would result in either higher taxes or less money for education. Galloway called that “a false choice.”

“It’s just an indication of how they would implement Medicaid expansion,” she said. “You can certainly see in some of the other states that there doesn’t have to be that choice.”

‘We can all go out there and do a study. There’s different sources you can get data (from) if you want to be on one side. ... If you’re on the other side, sombody’s going to give you data.

MIKE PARSON MISSOURI GOVERNOR

‘It is ridiculous. (Seven) rural hospitals have closed. We have folks driving hours to find health care. Expansion will cover hundreds of thousands of additional people, will provide hundreds of thousands of jobs and will have a budgetary benefit to our state.

CRYSTAL QUADE HOUSE MINORITY FLOOR LEADER ‘

‘There have been multiple studies that have shown that Medicaid expansion will actually save money in the state’s budget.’

NICOLE GALLOWAY STATE AUDITOR