Kinder slams federal health care bill

Lt. Gov. Peter Kinder stepped up criticism of the federal health care legislation today, warning that a provision forcing the state to raise Medicaid eligibility could cause a budgetary calamity.

The federal health care debate is a monstrous and constantly evolving process. But one provision that has a strong chance of being in a final bill is a requirement for states to include all adults above 133 percent of the federal poverty level in Medicaid. Missouri's current eligibility rates are much lower than that number.

Based on the bill that came out of the Senate Finance Committee earlier this month, the federal government would pick up most of the expansion's cost. But states, such as Missouri, would have to pay a percentage of the increase. 

Republicans - and some Democratic governors - have spoken out against the proposal. Kinder cited Tennessee Gov. Phil Bredesen's opposition in the video below:

The cost that Kinder cited seems to echo a letter from House Budget Chairman Allen Icet, R-Wildwood, and Senate Appropriations Chairman Gary Nodler, R-Joplin. That letter cited a Department of Social Services estimate that the provision would cost the state anywhere from $392 million to $454 million.

Scott Rowson, a spokesman with the Department of Social Services, said that number cited in the letter was an accurate estimate based on the provision's parameters in August. He said a new estimate taken earlier this month based off the Senate Finance Committee's bill would put the cost at about $91 million for the state.

It should be noted, however, that the parameters of the Medicaid expansion provision are not set in stone and could change. And that figure above is predicated on whether the federal government pays for the expansion indefinitely. If the feds stop paying for the expansion, then the state would be on the hook for a whole lot more money.

Also worth noting is that the change would only go into effect if Congress actually passes health care legislation, which is not necessarily a sure thing. But most people I talked to this week agree the Medicaid provision has a strong chance of making it into the final bill.

I asked Nixon about this top and also asked if the Medicaid provision made him not sign a letter expressing support for the federal health care effort. Take a look: