On A Mission To Expand Missouri\'s Medicaid Program
Christopher "Kit" Bond is back.
The two-term governor (1973-76 and 1981-84) has been walking the Missouri Capitol's hallways and meeting with legislators, some of whom weren't born when he first came to Jefferson City as state auditor in 1970.
Bond's Columbia, Mo.-based consulting firm, Kit Bond Strategies, was hired in January by the Missouri Chamber of Commerce & Industry to lobby for legislation that would expand Medicaid to about 300,000 low-income adults.
Bond didn't just put his name on the campaign. He has taken an active role in shaping the plan and delivering the message.
"He's no show pony," said Brendan Cossette, a chamber lobbyist. "He's engaged."
Bond said in an interview recently that he has met with 15 to 20 state senators, including some of the Senate's staunchest Obamacare opponents.
Though Bond strongly opposed the Affordable Care Act when he was a U.S. senator, he said it's time for legislators to ask themselves: "Did you work to get a responsible solution? Or did you just dig in your heels and say, 'Philosophically, I'm opposed to it.'"
He said he asks them to consider the price of inaction, including "how much money would come to Missouri that does not come here, how many health providers lose their jobs, how many needy people wind up in the emergency room to get primary care, which will drive up the cost of insurance that pays for the hospitals' cost."
Bond and his team worked with Sen. Ryan Silvey, R-Kansas City, to draw up a plan that attempts to address the critics' main concerns, such as whether the state could afford the $200-million-a-year cost of the new Medicaid participants once Missouri had to pay 10 percent of the bill.
Basically, Silvey's plan would pay for the newly eligible adults with savings the state expects to accrue from shifting some people to federally funded health care. If the federal government reduced the share it promised to pay, the state would cut off the coverage.
Other ideas in Silvey's proposal are listed under headings such as "entitlement reform" and "taking ownership act." They include greater use of private managed care plans, co-pays for inappropriate use of emergency rooms and photo IDs to reduce food stamp fraud.
"It's a workable plan," Bond said. "It protects the state budget and it provides the hardworking Missourians who are in the (coverage) gap with health care coverage and it allows us the chance to bring some sound principles" to managing Medicaid.
"It's a Missouri solution," he said. "This is the one opportunity to get some real reform in Medicaid. My good conservative friends and I have been talking about getting reform, because the system right now is not under control."
Silvey was a logical choice to carry the ball: He is a former legislative aide to Bond.
The chamber's president, Dan Mehan, also once worked for Bond, as did another key Medicaid lobbyist, Joe Pierle, executive director of the Missouri Primary Care Association.
Said Bond: "It's sort of like a reunion, but I trust all those people, they trust me."
Bond, 75, splits his time between his family's homestead in Mexico, Mo., and a home in St. Louis. He said he has generally been meeting with senators one-on-one. No session is planned with the Senate Republican Caucus.
"They've been very kind to let me hang around the Senate, but I don't envision them inviting me to the caucus," Bond said.
Though there are only six weeks left in the legislative session and opponents have promised to filibuster the bill in the Senate, Bond optimistically called the issue a "toss-up."
"At one point they were calling us Don Quixote, tilting at windmills, but the Don Quixote folks are making some strong points," Bond said. "All we want is careful consideration by the members of the Senate on what happens to Missouri if this doesn't pass, and what happens if it does."
Kaiser Health News is an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente.
