Speaker Elijah Haahr at the dais of the Missouri House of Representatives/Photo courtesy of the Missouri House
By BRENT MARTIN
St. Joseph Post
Missouri House Speaker Elijah Haahr had sort of a homecoming of his own at Missouri Western State University, visiting the St. Joseph campus to speak with Missouri Western officials, just prior to the kickoff of Homecoming activities.
The Speaker says many issues will face legislators when they return to Jefferson City in January and one recurring issue could face voters next fall.
Haahr remains opposed to Medicaid expansion under the Affordable Care Act, even as organizers gather signatures to place the issue on the ballot next year.
Haahr says Missouri had received a sharp increase in Medicaid recipients until federal regulations changed to end payments to those who didn’t qualify.
“The way the Medicaid system works best is that the dollars go to those people that are eligible and then whatever monies are leftover is money that we can invest in the hospitals and rural health communities in our state,” Haahr tells St. Joseph reporters after visiting with Missouri Western State University administrators.
Haahr, a Springfield Republican, graduated with honors from Missouri Western in 2005 before getting his law degree from the University of Missouri in 2008. He practices law in Springfield. First elected to the Missouri House in 2012 as a 29-year-old, Haahr became Speaker of the House last year, the youngest Speaker in the country.
It is estimated that expanding Medicaid under the ACA would add 200,000 Missourians to the Medicaid rolls. The cost is estimated at between $200 million and $400 million, even with the federal government footing 90% of the cost.
The Republican-controlled legislature has resisted for years efforts to expand Medicaid.
Haahr is concerned about the additional cost, but says that isn’t his only concern.
“Medicaid operates on a reimbursement basis. A lot of the providers in the state are concerned, because their reimbursements are not high enough,” Haahr says. “Well, if we expand the pool of people that are in Medicaid, but we don’t change the reimbursement numbers, you’re going to have more and more hospitals and health centers that say we just cannot afford to treat Medicaid patients. And then we have another issue of that access to health care on our hands.”
Those who support Medicaid expansion disagree with the Speaker’s conclusion. While they agree expansion would cost the state, they contend the influx of federal matching funds would boost the state economy. They also argue a healthier workforce is a more productive workforce.
An effort is underway to gather enough signatures to place Medicaid expansion the ballot next November.
Expansion would include a family of three making $18,000 a year up to nearly $30,000; families supporters say that do not qualify for Medicaid, but cannot afford private health insurance. Thirty-six states have expanded Medicaid.
Haahr says he disagrees with those pushing to expand the program.
“But the goal at the end of the day, both sides agree, is trying to figure out how we can get people into those health care clinics and get them treated, because treatment on the front end saves all that money on the back end,” according to Haahr.
Haahr adds it is likely organizers will gather the signatures needed to place the issue on the 2020 ballot.