Missouri governor backs Medicaid expansion under 'ObamaCare'

Missouri Gov. Jay Nixon (D) said Thursday that he plans to take part in the Medicaid expansion included in President Obama's healthcare law.

Governors are split on the Medicaid expansion — even some Democrats worry about the cost of taking part, while Republicans are under pressure to reject the expansion along with state-based insurance exchanges.

Nixon is legally prohibited from acting on his own to set up a state-based exchange, thanks to a ballot measure that requires approval from the Republican-controlled legislature to create an exchange. 

But Nixon said Thursday he intends to press ahead on the health law's Medicaid expansion — the other central component in extending healthcare coverage to millions of uninsured people. 

"My consistent position on expanding Medicaid has been to carefully study the options and then determine what is the best fit for Missouri," Nixon said in a statement. "That is why the budget I plan to submit to the Legislature for Fiscal Year 2014 will include federal funding to provide healthcare for an estimated additional 300,000 Missourians -- men, women and children -- who currently have no health insurance. It's the smart thing to do, and it's the right thing to do."

As Nixon noted, the federal government will initially cover the entire cost of the expansion in states that choose to participate. The federal share begins to fall gradually in 2017, bottoming out at 90 percent in 2020.

The Obama administration has emphasized the generous federal payments in pushing states to accept the Medicaid expansion, and it has said states that opt in now can back out once they become responsible for more of the expansion's costs.

Until the Supreme Court made the Medicaid expansion voluntary, it was set to cover about half of the roughly 30 million uninsured people set to gain coverage under the Affordable Care Act. That share will fall as states opt out of the program, so each state that signs on is a boost to the law's ultimate chance of success.

— This post was updated at 12:18 p.m.

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