Mo. House passes $25B budget without Medicaid plan

JEFFERSON CITY, Mo. (AP) -- The Missouri House passed a nearly $25 billion budget Thursday that would fund modest increases for public education but not a Medicaid health care expansion for lower-income adults sought by Gov. Jay Nixon.

House approval of the 2014 budget plan sends it to the Republican-controlled Senate, where more changes are likely before an early May deadline to get it to the governor's desk.

Nixon, a Democrat, had recommended spending more than $900 million of federal funds to expand Medicaid coverage to an estimated 260,000 adults living either in poverty or slightly above it, as called for under President Barack Obama's health care law. But the Republican-led House refused to include the money in the budget, citing concerns about the future costs of a Medicaid expansion while pledging to keep working on an alternative.

The House budget plan also pares back Nixon's recommended funding increase for public colleges and universities, but generally adopts his suggested increase for K-12 education. Overall, the $24.8 billion budget to take effect July 1 would rise about 3.4 percent from the current year.

House Speaker Tim Jones said representatives had passed "an incredibly responsible budget."

"More money is being spent on education, more money is being spent on essential services," said Jones, R-Eureka. He later added: "We need to make Medicaid better before we dump billions of dollars into a system that many say provides poor health care outcomes."

Many Democratic lawmakers registered their discontent by voting against the two bills funding the departments of health, mental health and social services — where the additional Medicaid money would have gone.

"We are talking about turning away billions of dollars in investment in our state simply because we have ideological differences," said House Minority Leader Jake Hummel, D-St. Louis.

Nixon, who met with House Democrats before the budget votes, said in an interview that he remains hopeful that lawmakers will still approve an expanded Medicaid program and restore the federal funding to the state budget. The governor said he's open to an alternative modeled after an Arkansas plan, in which federal Medicaid funds could be used to buy private insurance policies instead of enrolling people in a traditional government-run program.

Nixon traveled Thursday to rural Hermann and Perryville, where local leaders voiced support for an enlarged Medicaid program.

"If we fail to move forward with Medicaid expansion, communities, families and businesses in southeast Missouri will face higher health care costs and fewer jobs," Perryville Mayor Debbie Gahan said in a statement issued by the governor's office.

States that expand adult Medicaid eligibility to 138 percent of poverty — an annual income of more than $15,800 for an individual — can receive full federal funding for the first three years, starting in 2014. After that, those states would pay a share that gradually increases to 10 percent by 2020.

Republican senators have been equally resolute as their House counterparts against expanding the current Medicaid program, but have similarly left open the possibility of adding adults to the rolls if they are able to re-make Medicaid to more closely resemble private insurance.

The House budget plan would provide a roughly 2 percent increase for public K-12 schools, colleges and universities. That equals a $65 million raise to the $3 billion of basic state aid to public school districts but would still fall $620 million short the amount called for under a state formula.

Higher education institutions would get an additional $20 million compared with the current year. That's less than the $34 million increase sought by Nixon and would leave colleges and universities with about the same amount they were budgeted to receive a decade ago — before a couple of economic downturns forced cuts.

Missouri's Tourism Division would get one of the largest percentage increases in the budget — going from nearly $14 million this year to almost $20 million next year. Yet even that would not return the state's tourism promotion efforts to their pre-recession levels.

Some lawmakers argued that Missouri could reap more tax revenues by pouring even more money into marketing the state.

"Here's an industry that is almost similar to a cow, when you feed it, it will give you more milk," said Rep. Warren Love, R-Osceola.

Moments after the House passed the 13 budget bills, some senators said they intended to hold up the funding bill for the Department of Revenue because of concerns about the agency's new procedures for issuing drivers' licenses. Republicans don't like the fact that the agency is scanning copies of people's personal documents, such as birth certificates and conceal gun endorsements, while contracting with a business to print the licenses instead of doing so at local licensing offices.

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Budget bills are HBs1-13

Online:

House: http://www.house.mo.gov

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