Patrick Ishmael
On Wednesday, the Missouri Hospital Association (MHA) and the Missouri Chamber of Commerce held a press conference touting a report which portrays the expansion of Medicaid under the Affordable Care Act as a "reform." It is not, as I have reiterated time and time again. It is not "a jobs program." Other states will not "get Missouri's money." It is a fiscal sinkhole that is not funded, but the MHA and Chamber are OK saddling taxpayers with the cost.

Let me briefly set the rhetorical stage on the Missouri Medicaid news of the last couple weeks that these two groups, in large part, have driven. First, hospital groups favored the enactment of the Affordable Care Act in 2010, and the Missouri Hospital Association even went so far as to oppose Proposition C, the Health Care Freedom Act, later that summer. Hospitals want, and have wanted, the Affordable Care Act for some time; it is not surprising that they would demand that the state expand Medicaid under that program.

Second, the Missouri Chamber of Commerce has supported pricey government programs in the past, and the Medicaid expansion is a doozy. Readers may remember that the Missouri Chamber was a key supporter of one of the biggest proposed boondoggles of the last decade, the Aerotropolis project, and that project was "only" a half billion dollars. The Medicaid expansion? The cost is upwards of $3 billion to the state, and billions more to the federal government (a government which we, of course, also fund.)

Lastly — and tying this all together — that MHA poll from last week was "reviewed" for an organization I cannot find by a lobbyist for a Medicaid managed-care provider, a lobbyist who worked side-by-side with the Chamber two years ago on . . . the Aerotropolis legislation.

We have seen this all before, and around we go yet again.

Stated simply: expansion is not reform. The tactics being used to re-package and re-message the issue are about as predictable as those used to promote Aerotropolis. Indeed, some of the same parties involved in Aerotropolis are involved in the Medicaid expansion. That fact should give us all some pause.

About the Author

Patrick Ishmael

Patrick Ishmael is the director of government accountability at the Show-Me Institute.