Medicaid expansion decision impacts NRMC

Nevada Daily Mail

Nevada Regional Medical Center's finances may see another hit because of Missouri legislators' refusal to expand Medicaid.

NRMC board president Glenn Rogers said legislators in Missouri are leaving $2 billion in federal money on the table, which would better fund Medicaid and Medicare dependent hospitals like NRMC.

Board member Bill Turner said he told State Representative Randy Pike a lot of hospitals might fold because of it.

"I am making no personal application of any kind," Rogers said, "but I did jot down a quotation from French philosopher Montaigne, 'Stubborn and ardent, clinging to one's opinion is the best proof of stupidity.'"

Because the Affordable Care Act included an expansion of Medicaid to cover a larger number of low-income people beginning Jan. 1, 2014, states have begun deciding on what the expansion will look like for their own Medicaid program.

Under the Medicaid expansion, coverage would expand to cover all non-Medicare eligible individuals under age 65 whose incomes are up to 133 percent of the federal poverty level. Modified adjusted gross income will be used to determine the eligibility.

In Missouri, categories of groups currently include parents with incomes at or equal to 19 percent of the FPL, pregnant women under 185 percent of the FPL, disabled individuals under 85 percent of the FPL, Missourians 65 and older up to 85 percent of the FPL, blind individuals up to 85 percent of the FPL, qualified Medicare beneficiaries up to 100 percent of the FPL and children under age 19 under 300 percent of the FPL, according to a report by the University of Missouri.

Senator Ed Emery said in a press release expanding Medicaid in Missouri would wreak havoc on the state's already thinly stretched budget, leaving the potential open for disastrous hits to state programs and services.

"With a national debt that has reached more than $16 trillion, the federal government has proved itself to be an untrustworthy collaborator with regard to finances," he said. "Missouri needs to tailor its own plan regarding the health care needs of citizens -- not jump on board with an unstable plan molded by the federal government."

Emery suggested Missouri should focus on ways to reduce health care costs for individuals and empower the people to make important health-related decisions instead.

"Competition and transparency are central for a successful health care system," he said. "One alternative to Medicaid expansion would be Certificate of Need reform to allow for more competition between hospitals, thus driving down medical costs. Another option, highlighted in SB 307, would include allowing individuals access to information pertaining to the costs of medical procedures, so they are able to compare costs at different facilities."

A report by the Missouri Chamber of Commerce and Missouri Hospital Association said a survey of Missouri's hospitals showed a reduction of nearly 1,000 full-time equivalent positions and the implementation of a hiring freeze for another 2,145 positions because of federal funding cuts.

Governor Jay Nixon said the move has already cost more than 3,000 jobs in health care in the last six months.

"Fortunately, there is a clear path -- and plenty of time left in the session -- for the General Assembly to prevent further damage to our economy and put the needs of Missouri families first," Nixon said in a press release. "By expanding and reforming Medicaid, we can reverse these harmful job cuts, stop the flow of Missourians' tax dollars to other states and bring affordable health coverage to hard-working Missouri families."