On June 28th, the United States Supreme
Court upheld key provisions of Obamacare. As a result of a portion of the
ruling, Missouri must decide how to implement a healthcare exchange. We've
already seen the impact of Obamacare on Medicare with the major loss of dollars
to our local hospitals as it came to light over the last month. For example,
Heartland Hospital in St. Joe which provides healthcare for all of Northwest
Missouri is slated to lose over $300,000 a year because of cuts to Medicare in
Obamacare. That is why we must be deliberate and careful how we create an
exchange.
So what does this mean for the future of healthcare in
Missouri, and what are we going to do about it? Those questions are what makes
'Prop E' on the ballot in November so very important. This initiative, if
passed, ensures that the legislature creates our state healthcare exchange - not
the Governor. I believe this is fundamentally important because of the public
debate and the deliberate, calculated committee process we use to write laws. It
is always better when the public knows what is going on through lawmaking rather
than an executive order by a Governor. The legislative process ensures
accountability. We saw what Governor Nixon's intentions were this year as it
relates to Obamacare when he snuck a $50 million Medicaid expansion line item in
his budget. He was trying to begin implementation of Obamacare thru Medicaid
expansion as our state healthcare exchange. Fortunately, we in the budget
committee caught on to his scheme and tossed out his entire unbalanced budget.
Not only did he try to cut higher education by 10%, but he was also trying to
implement Obamacare without telling anyone! Now I hear on the radio he takes all
kinds of credit for signing the legislature's balanced budget. It must be nice
to be able to take credit for other people's hard work. I'm expecting a thank
you note from the Governor any day now....
The most significant other aspect of this decision was
that the Court ruled the federal government could not punish states which choose
not to use Medicaid as the state's healthcare exchange. During the public debate
concerning Obamacare, little attention was made to the tremendous cost shift
from the U.S. government to Missouri provided in this law. In order to reduce
the projected cost of this legislation, President Obama and Congress tried to
mandate that Missouri pay a large portion of the additional cost associated with
the expansion of Medicaid - the federal and state health insurance program for
the poor. Even with this accounting trick, the projected cost of this
legislation has sky rocketed since its passage. According to the nonpartisan
Office of Management and Budget, the projected cost of Obamacare has tripled
since its original adoption. TRIPLED, folks!! This is why Governor Nixon's
attempt to use Medicaid as our exchange was so very wrong.
In Missouri, we estimate this law will cost Missouri
taxpayers from $300 to $600 million in the first year if we accept it. Missouri
has a general revenue budget of almost $7 Billion and can ill-afford this cost.
Accepting such additional cost for Missouri would not be possible without
drastic cuts in the budget or an increase of taxes. I certainly oppose an
increase of taxes, particularly in these difficult economic times. In 2010, 71%
of Missouri voters rejected Obamacare in a statewide vote on Proposition C. We
need to see a similar percentage on Prop E, and I would strongly encourage
everyone to support it. Writing a healthcare exchange will be incredibly
important. We have to get the best possible version and I truly believe this is
only possible through the legislature.
It is an honor to serve as your Missouri State
Representative, and I do appreciate your input on matters of importance to you,
your family and community. Please feel free to contact me at 573-751-4285 or casey.guernsey@house.mo.gov. Thank you for taking an active
role by voicing your opinions on our state and national governmental
matters.
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