Missouri Punts On Medicaid Expansion

It looks like our neighbors to the north are going to punt, at least for now, on Medicaid expansion.  According to Politico, Missouri state legislators chose to send the issue to committee for study and will not take it up at least until 2014.

Of course, there are interesting parallels being Missouri and Arkansas.  Both have Democratic governors – Missouri Gov. Jay Nixon won re-election in 2012 with about 55% of the vote and happens to share some of the same political consultants as Gov. Beebe.

But both states also have Republican majorities in the state legislature.  In Missouri, the GOP has slightly stronger majorities with 106 out of 163 seats in the State House and 26 out of 34 in the State Senate.

It is still interesting to note the different paths they have taken, although it might make sense that the “Show Me State” would take a wait-and-see approach before doing anything.  It takes guts to be a state that tries a new approach as Arkansas is doing.

Politico makes this observation…

(Gov Nixon is) one of four Democratic governors who have struggled with Republican-led legislatures. Gov. Mike Beebe of Arkansas is the only one who succeeded in pushing through a plan to expand Medicaid. Gov. Steve Beshear of Kentucky says he’ll make a final decision on expansion by July 1, according to the Lexington Herald-Leader. And Gov. Steve Bullock of Montana has said he would consider calling lawmakers into a special session to revisit the issue, although there are no formal plans for that yet.

I will also make a clumsy segue into a plug for my weekly Stephens Media column which looks at Speaker Davy Carter’s role in tackling the uphill battle of health care reform in the legislature. (I should also note and perhaps should have been more clear in my column on the heavy lifting from Rep. John Burris and on the Senate side from President Pro Temp Michael Lamoureaux, Sen. Johnathan Dismang, and Sen. David Sanders among others.)  But back to my column on Carter’s man-in-the-middle approach…

Carter’s ability to find middle ground while holding to his conservative principles certainly makes him an attractive Republican candidate for the general election, but his biggest hurdle is getting past the primary.

Former Congressman Asa Hutchinson has already announced for the race and jumped to an early start in support and fundraising. In addition, with several statewide races under his belt — all unsuccessful — Hutchinson has broad name recognition not usually enjoyed by legislative leaders.

Perhaps more importantly, Hutchinson represented Northwest Arkansas in Congress. That part of the state generally has made up a sizable chunk of Republican primary voters, although some gains have been noted in other areas.

To be successful, Carter would have to increase Republican primary turnout in the central and southern parts of the state and even pull in voters from the Delta, where he grew up. He would also have to divide Hutchinson’s base while the third candidate, Curtis Coleman, pulled away more Hutchinson votes from the tea party wing.

The situation appears as daunting as getting any form of federally funded health care reform through the Legislature must have looked in January. If his mindset as speaker is any indication, that won’t deter Carter.