Obamacare Post Supreme Court Ruling - Missouri Must Opt Out of the Medicaid Expansion

In 2009, Congress passed the Affordable Care Act (ACA). Commonly known as "Obamacare," the law fundamentally changes health care in America. At the heart of the bill is the individual mandate, which requires every American to purchase health insurance. The ACA also mandated massive expansion of states' Medicaid programs. Prior to the Supreme Court ruling, this government coverage was traditionally for the poor or disabled. States that don't go along with this expansion faced having all of its federal Medicaid funding withheld.

After passage by Congress and the president's signature into law, the ACA was almost immediately challenged in court, eventually reaching the U.S. Supreme Court. Last month, the court ruled on the constitutionality of the ACA. In a 5-4 decision, the Justices upheld the law, saying the individual mandate is constitutional under the clause that grants Congress the authority to tax. The court did rule, however, that the federal government cannot hold states' Medicaid funding hostage to force them to expand its eligibility.

The ACA provides that the federal government will pay for the first three years of a state's Medicaid expansion, after which the state will pick up a percentage of the costs, maxing out at 10 percent. If Missouri chooses to expand its program, Missouri taxpayers are projected to be responsible for $100 million per year starting in 2017, eventually growing to approximately $150 million per year by 2020.

If you've ever seen a credit card commercial offering 0 percent APR for the first 12 months, or subscription services that give you the first month free, you're familiar with this approach. It's the same old song and dance. Get them hooked, and keep them paying for life, when we all know it is not affordable.

Missouri can't afford to expand its Medicaid program. We can't afford it now. Our current program covers more than 900,000 Missourians, at a huge cost to the state. The budget for Fiscal Year 2013 includes $8.2 billion for Medicaid, with $1.7 billion coming from state general revenue. Nearly a third of our budget goes to this entitlement program, and it grows every year. If we expand Medicaid, it would add approximately 300,000 more people to the welfare rolls and would be a fiscal disaster for Missouri taxpayers.

We just passed one of the most difficult budgets in decades, and according to economic forecasts, it's not going to get easier anytime soon. To balance the budget, some lawmakers proposed taking away health care for low-income blind people. Higher education absorbed yet another year of cuts. K-12 education is underfunded by $700 million annually, according to our foundation formula. Our roads are falling apart. The list goes on and on. Yet somehow, if we listen to the Washington politicians, Missouri needs to come up with an extra $100 million a year so select people can get free, taxpayer-funded health insurance, all to meet a draconian mandate issued by an over-reaching federal government, which, by the way, can't afford to pay out billions of dollars for these Medicaid expansions either. The United States is already facing trillion-dollar deficits.

Missouri must opt out of the ACA Medicaid expansion. The fiscal stability of our state and our country is already at risk, and neither will survive this new explosion in government spending. Stop spending, stop spending, stop spending, for the love of God and country and our future, stop spending.

In November, voters will have a chance to express exactly how they feel about the policies enacted by the current president and Congress. We have the power to steer our country in the direction we choose. Exercise that power. Stay informed. Become politically active in your community. Follow the candidates. Learn where they stand on this issue and others that are important to you. Let Washington and Jefferson City know how you feel about the ACA and its effect on our country and state. Vote!

Contact Me

As always, I appreciate hearing your comments, opinions, and concerns. Please feel free to contact me in Jefferson City at (573) 751-2459. You may write to me at Jason Crowell; Missouri Senate; State Capitol; Jefferson City, MO 65101, or e-mail me at: jcrowell@senate.mo.gov or visit me on the web at www.senate.mo.gov/crowell.