Missouri- Gov. Nixon Taking a Cautious Approach

Gov. Jay Nixon has taken a quiet, careful approach to the controversial measure. While Nixon’s top health appointees have pursued many of the new federal funding opportunities under the Affordable Care Act, the Democratic governor hasn’t put Missouri on the map as an early innovator in transforming health care delivery.

And because of opposition among Republicans in the state Senate, Missouri is at an impasse when it comes to setting up a health care exchange, a cornerstone of the federal overhaul.

Nixon has been “cautiously supportive,” said Ruth Ehresman, director of health and budget policy at the Missouri Budget Project, an advocacy and research group that focuses on helping poor and vulnerable populations.

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“It appears that he is been actively studying all of the requirements under the law and has been taking steps to meet them in a timely fashion,” said Sen. Rob Schaaf, R-St. Joseph, a vocal critic of the Affordable Care Act and leader in the effort to block a state-based health exchange.

Schaaf has sponsored legislation that would bar Nixon from creating a state-based health exchange through an executive order. The legislation would also prevent any state agency from setting programs or issuing rules for an exchange unless the legislature has specifically granted that legal authority.

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Lawmakers in the Missouri state House passed legislation earlier this year authorizing a statebased exchange, but that proposal died in the Senate. When Huff and others tried to move ahead on spending the $20 million federal grant, Schaaf objected, saying the governor was trying to make an end run around the legislature.

“The state is in a bit of a holding pattern,” said Jennifer Tolbert, director of state health reform at Kaiser Family Foundation, a nonpartisan health research group. That could cause problems down the line, Tolbert said, noting that many states need to dramatically upgrade their computer systems to make an exchange functional.

To make all that happen, Tolbert said, a state’s information technology system will need to be able to communicate with the federal government (to determine, for example, which Missourians are eligible for federal insurance subsidies). 


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“These (IT) systems are antiquated in a number of states, so you’re talking about building from scratch an eligibility and enrollment system, plus a system to certify health plans and (allow for) transparent, comparable information,” Tolbert said. “So there are a lot of pieces.”


http://www.news-leader.com/article/20120129/NEWS11/120129002/0/COMMUNITIES0201/?odyssey=nav%7Chead
Hat tip: Springfield News-Leader