Sen. Schaefer defends opposition to Medicaid expansion

Sen. Kurt Schaefer, R-Columbia, and Rep. Caleb Rowden, R-Columbia, addressed a crowd of about 45 people hosted by the Boone County Pachyderms Club on Tuesday evening.
The bulk of the meeting centered around the legislature’s refusal to expand Medicaid. Four people came to the meeting wearing signs that read, “Full Medicaid expansion now.” For about an hour, they debated Medicaid expansion with Schaefer.
One of the protesters brought up recent layoffs at MU Health Care and Boone Hospital Center, sparking the discussion over Medicaid. Last week, Boone Hospital Center stated it would be cutting 13 part-time and full-time positions, and MU Health Care said it would lay off or cut the hours for 35 employees and not fill 90 vacant positions.
“Boone Hospital’s message is they’re doing the layoffs because of Medicare reductions. Boone Hospital and BJC never said Medicaid,” Schaefer said.
He contrasted this with the reasons MU Health Care gave for eliminating positions.
“The university is going to lay off a handful of people and actually said, and I could not believe it, that they were going to lay people off because we didn’t pass Medicaid expansion,” Schaefer said. “The university hospital made $28 million last year, and they’re going to lay off, what, $200,000 worth of employees to make a statement on that.”
“I think that is absolutely irresponsible,” he continued.
Schaefer expressed his opposition to Medicaid expansion and the Patient Protection and Affordable Care Act as a whole. One reason he cited for not wanting to expand Medicaid is inefficiency in the system.
“You can’t fix the problem by simply pouring more money into it,” he said
He also said expanding Medicaid will affect other parts of the state budget, such as education.
“I am firmly convinced as the chairman of appropriations that there is no possible way to do Medicaid expansion and not have a serious negative impact on public education,” Schaefer said.
Proponents of the expansion have argued for months that it would provide relief to the working poor. They argue there are people who make too much money to qualify for the state’s current Medicaid eligibility, but not enough to pay for insurance on their own or pay out-of-pocket for health care.
For example, a single parent in Missouri with children would not be covered under the state’s current Medicaid system unless he or she made 18 percent of the federal poverty level, according to the Missouri Foundation for Health. 
“When you look at farmers and small rural communities, a lot of them don’t have access to work-based insurance,” said Brian Smith with the Missouri Rural Crisis Center, who attended the meeting wearing a Medicaid expansion sign. “So, you know, you’re looking at older populations, lower incomes, and they’re paying more for their insurance to begin with.”
Smith said the existence of small, rural hospitals is threatened without expansion.
“What happens is, they have to drastically cut services or in some cases even close,” Smith said. “Then that’s going to put more financial and just patient load pressure on places like Columbia, Springfield, St. Louis.”
“You’re right about some of those hospitals,” Schaefer replied. “I mean, there’s a question about the economic viability of some of those hospitals.”
Schaefer said rural patients often seek care farther away in a place like Columbia because of the high quality of care....