With several states weighing whether to expand Medicaid under the federal health law, supporters are looking to powerful business groups to help sway skeptical state legislators. But those groups are split on the issue — just like the public at large.
Nationally, the National Federation of Independent Business, which represents mostly small employers, remains opposed to the expansion, while the U.S. Chamber of Commerce has no position, saying it’s a state issue. Both organizations opposed passage of the law four years ago and the NFIB was one of the groups that took its challenge to the U.S. Supreme Court.
State business groups are also divided. Large business groups in Missouri, Texas, Idaho, Virginia, Alaska, Pennsylvania and Tennessee support expansion as way to help hospitals and lower costs for employers, while chambers of commerce in North Carolina and Georgia say they are unconvinced. The Florida chamber says it would support Medicaid expansion only if the state met several conditions, including lower medical malpractice costs and expanding residency training slots.
The level of commitment to the issue also varies. At one end of the spectrum is the Missouri Chamber of Commerce, which this year hired former U.S. Sen. Kit Bond to lobby the Republican-dominated state legislature to extend Medicaid coverage to 300,000 Missourians. Bond, a Republican, voted against the health law before he resigned from Congress in 2010.
Like other Republicans who favor Medicaid expansion, he insists his overall view on the law has not changed: “I have been and always will be opposed to Obamacare.”
But today he argues that expanding Medicaid to cover everyone with incomes under 138 percent of poverty level, or $15,800 for an individual, would protect the state’s safety net providers and save money for taxpayers and employers. That’s because under the law, hospitals lose Medicare funding and, without the Medicaid expansion, will not gain as many insured patients.
Bond said the chamber-backed bill would funnel millions of dollars in health law funding to buy private coverage for the poor similar to the approach used by Arkansas.
But the Missouri bill, which was introduced by two Republican House members, faces an uphill battle. Its first House committee hearing is set for Monday.
In February, the state Senate defeated Medicaid expansion on a vote of 23-9, with Republicans opposing the idea and Democrats supporting it. But supporters said that vote was not a true test because that bill did not include details that the chamber backs such as having people on Medicaid get coverage through private health plans.
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