Our opinion Medicaid ball now in GOP's court

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Posted: Saturday, January 12, 2013 11:45 pm | Updated: 11:18 am, Mon Jan 14, 2013.

Republicans in the Missouri General Assembly have their wake-up call: Put forward a better argument for opposing an expansion of Medicaid, or risk the scorn of all voters who desire to pay less and receive more in the way of government services.

Or, in the alternative: Make a pragmatic decision to expand the Medicaid rolls even though this has the taint of appearing to support President Obama’s health care overhaul.

This is not an easy decision for conservative leaders who want smaller government, fewer people on public assistance and larger influence in the halls of Jefferson City and Washington. But we suspect this same group also wants to be known for making logical, thoughtful decisions that improve the lives of citizens.

Sometimes what is needed is the fiscal equivalent of tough love. Unemployment benefits can run only so long, then even the unemployed have to accept what life has dealt them. Similar positions on a range of other issues are both defensible and honorable.

This instance appears different. As three studies and numerous advocacy groups have noted, the proposed expansion of the Medicaid rolls would be heavily financed by the federal government — 100 percent in the first three years and never less than 90 percent thereafter.

States that participate will have healthier families, lower health care costs impacting everyone, and a ripple of other economic benefits. None of these good outcomes will flow to those states that opt out.

The estimates vary, but a moderate projection holds that 218,000 Missourians would gain access to medical insurance through this change allowing participants to earn up to 138 percent of the federal poverty level. With that level currently at $23,050 for a family of four, it’s clear the challenges these families have in obtaining affordable insurance.

Under the unpopular federal health care act that now is the law of the land, Missouri hospitals stand to lose about $3.3 billion in federal reimbursements over the next seven years. However, if the state expands Medicaid coverage, it is projected to receive an additional $8.2 billion from the government in roughly the same period.

The most conservative study presented so far projects an additional 24,000 new jobs would be created in the state, due to this infusion of economic support. The new payrolls would total nearly $7 billion and there would be a $16 billion total impact on the state’s economy. Tax revenues to the state would increase by more than $850 million.

It’s also notable that rural areas of the state, due to their lower household incomes, would see some of the largest positive impacts.

Give supporters of this change, including Gov. Jay Nixon, their due: They have brought forward compelling arguments. The state GOP leadership must now either offer a substantive rebuttal or close ranks with those advocating for expanded health coverage that makes sense financially for the state.

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