“But a Constitution of Government once changed from Freedom, can never be restored. Liberty, once lost, is lost forever.”  — John Adams

An issue that has received much of the spotlight throughout the 2013 legislative session is the matter of Medicaid expansion, which is under the umbrella of the federal Patient Protection and Affordable Care Act, more commonly known as “Obamacare.” We should not forget that in 2010, more than 70 percent of Missouri voters made their voices clear at the polls, stating that they did not want the federal health care act’s overreaching mandates in our state. Expanding Medicaid in our state would wreak havoc on our already stretched-thin budget, leaving the potential open for disastrous hits to our state programs and services. Not to mention, 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. 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.

Several arguments advocating for Medicaid expansion tout misleading promises that don’t shed light on the whole picture. Some of those arguments include: the federal government will fund Medicaid expansion “for free” for the first few years; if Missouri doesn’t use its Medicaid funding, it will go to other states; and more people would be helped if they were added to the Medicaid program.

There is no such thing as “free money” — federal money comes at the expense of taxpayers. In addition, the federal money spent on Medicaid would only add fuel to the fire regarding our fiscal crisis.  Our federal government’s debts not only affect today’s generation, but will also impact the lives of our children and grandchildren. Missourians’ wallets would take a big hit after 2017, when the state would be expected to pay a percentage of the new program’s cost. A Show-Me Institute publication cites that, according to the Kaiser Family Foundation, Missouri could expect to spend more than $1.15 billion between 2013 and 2022 on newly eligible Medicaid enrollees alone.

The Heritage Foundation also notes that rejecting Medicaid expansion does not mean other states will receive more funding. A report on its website states, “The federal share of Medicaid is based on a formula calculation and actual expenditures. Rejected funds do not go into a general fund for redistribution to other states. The fewer states that expand, the less the federal government spends. States that draw down on these new federal funds fuel the fiscal crisis in our country.” The organization also points out that the Medicaid program is already struggling to assist citizens who rely on its services, and adding more people would ignite further problems for the Medicaid program. It wouldn’t be beneficial to citizens who receive Medicaid services to have watered-down health care.

Instead of Medicaid expansion, Missouri should focus on ways to reduce health care costs for individuals and empower the people — not the federal government — to make important health-related decisions. Competition and transparency are central for a successful health care system. 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.

We need to send a message to the federal government that a standard, one-size-fits-all health care plan is not in Missouri’s best interests. Greater dependency on the federal government is not the answer and is poor policy. Missouri is a state that prides itself on its AAA bond rating and living within its means. The Legislature needs to discuss common-sense solutions that will ensure citizens receive quality health care, without spending money in an irresponsible manner.

I appreciate you reading this legislative report, and please don’t hesitate to contact my office at (573) 751-2108 if you have any questions. Thank you and God bless.