On November 19, 2012, Missouri Governor Jay Nixon announced his intent to forward a Medicaid expansion budget to the Missouri legislature. Describing the move as both the right and the smart thing to do, Governor Nixon made his announcement locally at Truman Medical Center — one of Kansas City's safety net hospitals.
Based on the governor's remarks, Medicaid expansion is right because it is smart economically. Expanded Medicaid's value is both in expanded health insurance coverage and in job creation as well as tax revenue. You can read excerpts of his announcement here: http://www.news-leader.com/viewart/20121129/NEWS06/311290053/Nixon-Missouri-Medicaid-expansion-governor
The value of Medicaid as an economic engine for job growth is rarely discussed. Governor Nixon has it about right: the role of Medicaid in state and local economies is an under-discussed subject. Medicaid spending, particularly through the infusion of federal Medicaid dollars into state and local economies, generates activity around jobs and state and local tax revenue. And the extremely favorable FMAP for ACA Medicaid expansion (100% of total state contribution, eventually modulating to 90% of total state contribution) means the multiplier effect for the ACA Medicaid expansion would be particularly pronounced. The thought of spending 333 million dollars to bring over eight billion dollars over a seven year period into Missouri's economy might help to explain the Missouri Chamber of Commerce's position on Medicaid expansion.
If the debate about ACA Medicaid expansion in Missouri is to focus on fiscal responsibility, acknowledging the role of Medicaid in our state economy — and factoring in the economic growth as well as economic cost implications of Medicaid expansion — is a good place to start.