Nodler: Federal Healthcare Mandate Creates a Troubling Future

This week, the Senate continues to try to find ways to cut spending in the state. In order to balance the budget, the Senate made nearly $500 million in cuts to the governor’s original proposal. The budget is now in conference and House and Senate members are working hard to create a balanced spending plan for our state. This work has me looking to the future when, according to the federal healthcare plan passed by Congress, Missouri will need to come up with billions of dollars in additional revenue to fund expanded Medicaid eligibility. This ticking time bomb of fiscal irresponsibility is going to cause serious budget destruction down the road.

President Obama signed the federal healthcare legislation this year. The bill contains a significant expansion in Medicaid eligibility, adding 255,000 Missouri adults to the state-sponsored healthcare system by increasing eligibility caps by 113 percent. The federal government has tried to silence some state’s protests over the unfunded mandate by covering the costs of the expansion for the first three years it is in effect, but federal support will not always be available. Once Missouri has to start footing the bill, the Department of Social Services estimates the plan will cost our state an additional $1.34 billion from 2017 to 2023—a devastating price tag for our finances. These are Missouri taxpayer dollars that the federal government is forcing us to pour into healthcare costs.

This expansion is costly and fiscally irresponsible, but the federal government has stripped control away from our state. This action threatens the availability of healthcare as well as the health of Missouri’s future finances. No matter what actions we take in the coming years to balance our books and cut spending, this aspect of our budget will be out of our hands come 2017 when we will have to spend an additional $99.2 million to meet federal regulations. We have created a tradition of fiscal responsibility in Missouri, but our careful planning will be for naught if we are forced to spend taxpayer dollars on federal mandates.

States throughout the nation are in fiscal crises, and I am proud to say that Missouri is fairing better than many other states in the nation. During my time as appropriations chairman in the Senate, we maintained one of the highest carryover balances in Missouri's budget history, held on to Missouri's AAA bond rating, and passed responsible, sustainable budgets. However, forcing us to pick up the cost of expanding healthcare will be detrimental to our careful efforts. Asking the states to shoulder the burden of this federal mandate just shows that the healthcare plan passed by Congress is short-sighted and detrimental.