One of the most talked-about issues at the Capitol is the matter of Medicaid expansion, an element of the federal health care law that calls upon the states to expand Medicaid eligibility to cover more citizens’ health care needs. The federal government touts that it will provide Missouri with federal funding for a certain timeframe if we expand Medicaid eligibility to 138 percent of the federal poverty level. Although some may be lured by the federal government’s offer, we need to keep the larger picture of Medicaid expansion in mind. The flexibility of our state budget is limited and our debt-absorbed federal government may not be the best collaborator.

Many of us know the expression, “If it sounds too good to be true, it probably is.” This can be applied to the federal government’s offer to cover the costs for new Medicaid enrollees. There is no such thing as “free money” — the federal government is borrowing money from China to fund our country’s programs. With a federal debt that has reached as high as $16 trillion, the federal government is not in a position to liberally spend or offer money. That debt is not only a burden to us, but will be a large weight on the shoulders of our kids and grandkids. Spending money without a clear vision of the consequences is poor public policy.

Even if the federal government fulfills its promise to pick up the tab for Medicaid expansion for the first three years, Missouri would eventually need to find the money to pay for some of the Medicaid expansion costs. A Missouri lawmaker noted in the Liberty Tribune that if Missouri expands Medicaid, the state would be responsible for at least $100 million in new Medicaid expenditures by 2020, with that number rising as much as $150 million to $200 million. I have personally been informed by elected officials in Washington, D.C., to not expect the 90-10 ratio in funding to continue; those individuals think the ratio will decrease in the future. Will it drop to our current federal government to state funding ratio of 60-40? Medicaid funding has a huge effect on the amount of financial support the state is able to give to other important programs, such as education. We also need to address the problems of our current Medicaid program. I’ve heard estimates of 25 percent of funding for Medicaid going toward waste, fraud, and abuse. We need to ask ourselves if we want to expand a broken program. In addition, we need to ask ourselves if adding more people to the Medicaid program would dilute the quality of health care services that citizens receive under the program. If more people are covered by Medicaid, but their quality of care suffers, that’s not a beneficial outcome.

We need to send a message that a uniform health care plan is not for Missouri; we need to craft our own solution to ensure quality health care for Missourians. Lawmakers in Missouri are not sticking their heads in the sand. We are discussing the issues pertaining to health care and keeping an open mind as to how to create a healthier Missouri. Our approach is to reform a broken system, and then look at the possibility of expansion.

Another issue the Senate tackled this week was a bill to help protect your privacy and prevent the unjust actions demonstrated by the Missouri Department of Revenue (DOR) from happening again. I have discussed in previous legislative columns how my colleagues and I are taking action to ensure your private information remains confidential and is not carelessly passed around. The Senate gave initial approval to SB 252, which would prohibit DOR from retaining copies of source documents used to obtain or renew driver’s or non-driver’s licenses. To be sure your private information is safe from prying eyes, DOR would need to securely destroy any source documents that have been obtained from applicants after Sept. 1, 2012.

Senate Bill 252 would also change how the state handles the issuance of concealed carry permits. Under current law, citizens seeking to carry concealed firearms have to apply to the sheriff for a certificate of qualification for a concealed carry endorsement. When a Missourian is issued the certificate, he or she must present that document to DOR, which issues driver's or non-driver's licenses with a concealed carry endorsement. This legislation would repeal this provision and, instead, the permit issued by the sheriff authorizes the person to carry concealed firearms. When asked by a police officer, the concealed carry permit holder must display the permit and government-issued photo identification. Senate Bill 252 would require state agencies to destroy documents or records, including fingerprint records, provided by an applicant for a concealed carry endorsement prior to Aug. 28, 2013. Senate Bill 252 contains an emergency clause, noting the urgency of this issue. If passed by the Legislature and approved by the governor, the bill would go into effect immediately upon receipt of the governor’s signature.

If you have any questions about the matters I’ve addressed in this legislative report, please don’t hesitate to contact my Capitol office.

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