"This report clearly lays out that, as Medicare reimbursements go down, without these additional funds designed to balance the system and strengthen the system we will in fact move backwards." Nixon added, "Mental health and law enforcement are stretched to their limits right now, moving backwards in those areas would be dangerous for Missourians. We need to move forward."
According to numbers provided by the Office of the Governor, expanding the number of people eligible for Missouri's Medicaid system will bring $5.7 billion to the state and provide health coverage to an additional 300,000 Missourians over the next three years. The Governor contends the federal government would pay for all of those costs.
Republicans in the General Assembly, including House Speaker Tim Jones, have repeatedly expressed skepticism and said they will not agree to the expansion.
"Why should we pour billions of dollars of your hard-earned tax money into a broken system?" Jones said in his response to the governor's State of the State address. "That would defy basic economic sense."
Last week a House appropriations committee backed up Jones' words, voting down an attempt to add funding for the Medicaid expansion to the 2014 budget. At the same time, a House government oversight panel defeated a measure that would have put the Medicaid expansion into state law.
Both committees voted along party lines, with Republicans opposing the Medicaid expansion and Democrats supporting it.
Still, Nixon says he sees progress.
"We've had good and productive meetings with a number of senators," he said. "So I think that we are seeing improvement. I think the real challenge is to get past last November's elections and to get to the practicality of where we are right now."
The core of the governor's argument continues to be that if Missouri does not expand its Medicaid roles, the federal money for that expansion will go to other states. Missourians will be paying for residents of other states to get health care.
"As far as breaking down the political barriers, you can see it's happening all across the country," he said. "Just in the last month, Republican Governor Rick Scott of Florida is now for Medicaid expansion. Republican Governor Rick Snyder (of Michigan) moved forward on Medicaid expansion. Republican Governor John Kasich in Ohio moved forward on Medicaid expansion. The Republican governors of North Dakota, Nevada, Arizona, have moved forward.
"And others are joining them. We are quickly becoming a minority of states, a significant minority, who are not moving forward on this. And I think that's another thing that will help us move forward when talking with these (Republican) members, stressing the importance of this, stressing that we don't have time to wait, and that as others have studied this they have seen the clear path forward is to do this."