Issue link: http://accesshealth.uberflip.com/i/1022933
continuetobringeveryda y ,ordinarypeopletotheCapitol totalktotheirlegislators,"shesaid. Pierleaddedthatthelastlegislativesessionincluded "Republicanchampionswhoputpoliticalideologyaside andsteppedforward. W eintendtoworko f fthe momentumwehadinthelastsessiontocontinuetomake thecaseaboutwhythisissoimportant." Pierlealsou r gesvoterstotalktotheirrepresentativesand senatorsaboutwhythisisimperativetolocal communities."Ithinkit ' stimewemovepastwhetheryou areforObamacareoragainstObamacaretowhatimpactit willhaveonthelocalcommunit y ,"hesaid."Someho w , weneedtotakepoliticsoutofthisandbetterunderstand thatdecisionshaveconsequences. Andthesedecisions, whatevertheyare,aregoingtoimpactrealpeople." ArousingRepublicanvoterswillbeonestrategy advocateswillrelyoninthecomingmonths. T rupiano saidit ' sclearthatmanyRepublicansseehowexpanding Medicaidmakesforgoodhealthcarepolicyandgood economicpolic y ."Itjustmakesgoodsensealltheway around. Thedevilisinthedetailsforalotofour Republicanlegislatorstomakesurethatthisisareform billthatworkswellforallMissourians,"shesaid. Shesaidit ' salsoimportanttogetintouchwith Republicanvoterstomakesuretheirvoicesareheardand empowerthemtospeakoutabouttheirsupportfor Medicaidexpansionthatincludesreform."Lastyea r ,we cameverycloseandIthinkitisunfortunatethat2-3 senatorscanholdupalloftheprogressthathasbeen made.Sowearecontinuingtoworkonthoselegislators whostandinoppositionandhaverealdialoguesabout whattheyneedinordertomoveforward." Whenaskedifcostwasaviablea r gumentfornot expandingMedicaid,Hembreesaidexpansioncanhappen withoutbreakingthebank.Medicaidexpansionwas designedtousefederaldollarstopayforthelion ' sshare ofhealthcarecostsfornewlyeligibleenrollees.Howthat breaksdownisthatthefederaldollarswouldpay100 percentofthecostsfrom2014through2016.In2017,the federalgovernmentpaysfor95percentofcostsandstates willbeonthehookfortheremainingvepercent.In 2018,stateswouldpaysixpercentofcostsandin2019, sevenpercentandfrom2020on,states' responsibility wouldcapat10percent. HembreesaidthattheaddedcostsforMissouriwould leveloutassomeofthesafetynetprogramsitcurrently paysfo r ,likementalhealthforinstance,wouldnowbe coveredthroughtheexpansion. Additionaltaxrevenue wouldcometothestatethroughincometaxesgenerated byamorerobusthealthcareforce. Thenumbersalonepaintaclearpicture. A recentarticlein theKansasCityBusinessJournaltalksabouthow fo r -prothospitalsarefaringinstatesthatexpanded Medicaid.Inshort,hospitalssawadecreaseinuninsured patientsandanincreaseinMedicaidpatients. A PricewaterhouseCoopersreportrevealedthatHosptial Corporationof America"reviseditsearningsoutlookto accountforbette r -than-expectedrevenuefromhealth reform."Howeve r ,thehealthcaresystemdidnotdisclose actualnumbers. T enet,aDallas-basedhealthcaresystemthatoperatesin vestateswithexpandedMedicaid,sawa$78million reductioninunpaidcareinthesecondquarteralone, accordingthereport.Howeve r ,accordingtothe R WJ F , hospitalsinnon-expansionstatesaresettolose$167.8 billioninMedicaidrevenuebetween2013and2022. That includes$2.6billioninKansasand$6.8billionin Missouri. "Ianticipatethatifwecontinuetoplaypoliticswiththis issuelonge r ,attheend,everybodyisgoingtohurt—not justpeoplewhocouldhavebenetedfromMedicaid expansion,buteverybodyinacommunitywhocountson theirlocalhospital,clinic,physicianornurseisgoingto feeltheimpact. Thereareemptymedicalo f ces throughoutruralMissouritoday…Ianticipatethatthat ' s onlygoingtoincreasethelongerwedragourfeet,"Pierle said.