If Bob Yates hasn’t already most adequately and quite succinctly ridiculed Republican Senator Roy Blunt’s effort to avoid the obviously dishonest position of the Ann Wagners in the GOP, who want to assure the gullible masses that, yes, indeed, the most recent CBO report said that 2.5 million people would lose their jobs, Duane Graham at The Erstwhile Conservative has put finis to the task with a full and detailed takedown of the Fox News Sunday interview with Blunt. Graham and Yates both record the shift in Republican rhetoric from a false story about lost jobs to an ugly story about enabling “moochers” who, Blunt and his fellows imply, just don’t want to work. As Graham puts it:

… notice how Blunt, like all Republicans are now doing and will continue to do until election day this November, focuses on those alleged “2.3 million” people who “don’t want to work” or “don’t have to work.” That is essentially the argument that was made more generally during the 2012 election.

Read both pieces. Roy Blunt deserves everything that Yates and Gaham have to say about his despicable performance.

And when you’re done, read a couple of posts from Paul Krugman’s NYT blog to get a better idea about what is fueling Blunt’s nasty little insinuations and why they’re so bogus. According to Krugman, those who leave the labor force will reduce labor input and decrease GDP somewhat, but the fact that wages and benefits are not being paid to those leaving the labor force would perfectly balance the decrease, rendering the effect neutral, were it not that those individuals would also no longer pay the taxes that correspond to their lost labor. He concludes:

So yes, reduced labor supply adds modestly to the true cost of health reform, although it also adds to the benefits. But the key word is “modestly”.

Why, then, are the usual suspects so incensed? Partly because they don’t understand any of this. Beyond that, there’s a moralistic streak: people should be forced to work, for their own good, you see (are there no poorhouses?). And of course, there’s the underlying rage that a disproportionate share of the beneficiaries (though by no means a preponderance) will be Those People.

But when you take paternalism and prejudice out of the picture, what you’re left with is some pretty prosaic economics. Should you care how much other people work? Yes, a little – but not so much that it should change anyone’s views about health reform.

As to whether or not this shift in Republian rhetoric will have the desired effect, Krugman’s analysis of the initial strategic misfire suggests why it will not – at least, with anybody other than the true believers:

The thing is, my read […] is that the CBO affair actually ended up hurting Republicans. By the end of the week a barrage of press reports, plus those mighty figures Jon Stewart and Stephen Colbert, had effectively changed the story from “CBO predicts massive job losses” to “Republicans lie about CBO report.” In reality, it’s unlikely that it would have mattered at all even if the first story had stuck. But to the extent that such things matter at all, Republicans ended up losing the week.

It’s hard not to conclude that since everyone who’s paying the slightest attention knows that Republicans have been lying vigorously about the whole CBO business, why should they believe anything that mouthpieces like Blunt now have to say, no matter how much more subtle the latest story happens to be? What is even more interesting, though, is the fact that this exact type of talk, the 47% business, is what helped do Romney in back in 2012. Why does Blunt & Co. think it’ll be more successful now?  

Rep. Ann Wagner’s (R-2) is hopping mad – or, more likely, hopping around, trying to get off the liar’s hot seat (remember the refrain “liar, liar, pants on fire”?). What’s got her hopping? A recent editorial in the St. Louis Post Dispatch that had the temerity to suggest that the deficit was falling, the economic outlook is improving and that the findings of a Congressional Budget Office (CBO) report on Obamacare economic impacts have been grossly misinterpreted by folks like Wagner. So what does she do to relieve the gut-churning evidently induced by the good news? Why, write a letter to the editor, of course, insisting that they take it all back – a letter which she then proudly forwarded to her lucky constituents, a move meant, undoubtedly, to let the Tea Party types among them know what a big, fearsome Obama-hater she really is.

Rep. Wagner attributes her motivation for writing to her tender concern for constituents who, according to her claims, have been telling her about all the ways their lives  have been ruined by Obama administration policies, especially Obamacare:

Every day I hear from hardworking families in the 2nd District who are struggling to make it to the 15th and the 30th of every month in this tough economy. These are real people struggling under the weight of President Obama’s failed agenda.

Wagner added a few details in the constituent email:

Every day I hear from far too many hardworking families in the 2nd District who have seen their premiums skyrocket, their health insurance cancelled, who have been forced to change their doctors, and have seen their hours cut back at work.

I haven’t followed every pronouncement from Rep. Wagner on the topic of Obamacare, but when she starts moaning and groaning about her constituents’ Obamacare-related suffering, concrete details are few and far between. Which is probably intentional given that similar “true” stories promulgated by Wagner’s GOP colleagues have not been able to withstand close scrutiny. Remember, for instance, the subsequently debunked Bette story in Cathy McMorris Rogers response to the SOTU? Of course, it’s also likely that the complaints that she has received in response to her solicitations for Obamacare hardship stories reflect a partisan bias that skews perceptions. A Gallup poll released last week showed that only 19% of Americans said that they had been hurt by Obamcare and, of that 19%, 60% were Republican or Republican-leaning.  Which, in turn suggests that what Steve Benen identifies as political “tribalism” leads people to respond to polls – and requests from politicians for political ammo – in the way they think they should.

The real point is not that Missourians are suffering due to Obamacare, but that Rep. Wagner has invested lots of capital in questionable rhetoric and she’s up in arms  when folks like the Post-Dispatch editorial staff who, after looking carefully at the recent CBO report, point out that she and her GOP cohorts have distorted its contents. Her claims are simple:

The numbers in the CBO report couldn’t be clearer: Due to Obamacare, the equivalent of 2.5 million people will leave the workforce over the next 10 years, and government-run health care will add another trillion dollars to our national debt.

This is where the burning pants really ignite. Wagner is willfully wrong on both counts.

The CBO report does not say that jobs will be lost, just that some people will voluntarily leave the labor force or reduce their hours of work because they don’t need to keep working in order to secure affordable health insurance. Hours will not be reduced by employers, but by employees. In fact, as the Washington Post points out, “the CBO declares that ‘there is no compelling evidence that part-time employment has increased as a result of the ACA,'” thus  decimating one of Wagner’s talking points about employers cutting employee hours to escape paying for health insurance. There’s lots to be said on this topic, and I think most of it got said last week – and none of it supports Rep. Wagner’s hyperbolic assertions, including a statement from the author of the report she considers so clearly negative, CBO director Doug Elmendorf. In fact, as Elmendorf pointed out, the report indicated that Obamacare would have a positive employment effect:

Elmendorf also noted that the ACA is actually expected to boost the economy in the near-term by making health insurance and medical care affordable for the poorest Americans, giving them the freedom to spend money in other areas of the economy. “On balance, CBO estimates that the ACA will boost overall demand for goods and services over the next few years,” states the report.

As for the business about increasing the deficit:

…the CBO reduced its estimate of the net cost of the ACA by $9 billion through 2024, in part because of the number of states that have refused to implement the law’s Medicaid expansions. And the CBO still maintains that, over the 10-year window of its analysis, the ACA will reduce the federal deficit. In fact, that trend is expected to increase in subsequent years, with the ACA leading to greater deficit reduction.

So what should we think about Rep. Wagner’s whining ways? Paul Krugman’s summary of GOP duplicity could have been tailor-made to her measure:

… .Remember, the campaign against health reform has, at every stage, grabbed hold of any and every argument it could find against insuring the uninsured, with truth and logic never entering into the matter. Think about it. We had the nonexistent death panels. We had false claims that the Affordable Care Act will cause the deficit to balloon. We had supposed horror stories about ordinary Americans facing huge rate increases, stories that collapsed under scrutiny. And now we have a fairly innocuous technical estimate misrepresented as a tale of massive economic damage.

To conclude, sorry Rep. Wagner, but Obamacare is beginning to work out, the economy is getting better despite harmful GOP budget cutting, and lots of things are really getting better for lots and lots of Americans – despite the best GOP efforts to hide the truth.

( – promoted by Michael Bersin)

Today, Roy Blunt shows why we Missourians should be appalled that he represents us in the US Senate.

The following is taken from a posting on the Huffington Post.

As we all know, the CBO report did not say jobs would be lost because of the ACA.  So the new talking point is that the ACA discourages work. Today, on Fox News Blunt said the following:

“I think any law you pass that discourages people from working can’t be a good idea,” Blunt said. “Why would we wanna do that? How does that allow people to prepare for the time when they don’t work?”

If Blunt really believes that, then why do we have ANY law that discourages people from working?

After all, Social Security and Medicare allow people to stop working. Personally, both laws will allow me to retire before I die. Likewise, limiting the working week to 40 hours discourages work.  And, let’s not forget we have laws against child labor.

As we will see this week, Republicans used to think something must be done about job-lock, but not anymore.

Now, because the Republican MUST oppose anything Democrats propose, a law that makes it easier for people to change jobs or choose to retire before they die is destroying the American Dream (as (re)defined by the GOP).

I did not know that the American Dream was for all of us to work literally all of our entire lives.

Why is ANYONE a Republican today?  

Today TPM reports that former Florida govenor Charlie Crist, who is running against Medicare-fraud perpetrator Governor Rick Scott to regain the governorship of that state, spoke some home truths to MSNBC’s Chuck Todd about the consequences of failing to take advantage of Obamacare’s Medicaid expansion provisions:

About a million of my fellow Floridians are not getting health care today, and I am told by friends SEIU (sic), that means six people in Florida die every day as a result of that. Every day,” Crist said.

[…]

It’s not hard to figure that out. It’s common sense. Look at it. If people are sick, and they aren’t getting health care, what happens? They usually get sicker,” Crist said. “Or they die. I mean, those are just the facts, Chuck. That’s what happens. In addition to it, it’s economically stupid. As a result, we’re not getting $51 billion over the next 10 years for the health care institutions in Florida. So the people get better health care, so that kids don’t get sick, that we take care of people. That’s what public servants are supposed to do. That’s why I’m running against Rick Scott, because he’s not a good servant.”

The claim that six people will die daily if Medicaid is not expanded likely comes, as TPM noted, from a joint Harvard University and  City University of New York report published last month. You can quibble about the actual number – it’s an estimate after all – but the point is that people will die while ideologues posture and babble incoherently about “government dependency” and the “unsustainable costs” involved in directing federal tax dollars back to the home state.

What does this factoid mean for Missouri? Approximately 2190 yearly deaths that could have been prevented.

But we can take it farther. Most Republicans oppose expanding Medicaid and most Democrats support it. In the Missouri Senate, 24 members are Republicans; in the House, 106 representatives are Republicans, making a total of 130 Republicans running things in Jefferson City. We can do some rough math and conclude that if Medicaid is not expanded, each Republican in the legislature will be responsible for the death of 16.8 Missourians per year, give or take a few.

A crude, tongue-in-cheek exercise perhaps? But no matter, it’s a sure bet that there will be deaths as a result of the action – or rather inaction – of Missouri Republicans. And no matter how you count our dead fellow Missourians, they’ll amount to quite rack of trophies for each Missouri GOPer.

First sentence amended for clarity and a link was added.

Previously: Rep. Vicky Hartzler (r): “Seriously? You expect me to actually read the footnotes in the report?” (February 4, 2014)

You wouldn’t know that republicans were at the same hearing:

Conservatives Seize On Report To Argue Obamacare Is A Job Killer – But The Author Says They’re Wrong

By Sy Mukherjee on February 5, 2014 at 1:42 pm

On Wednesday, Congressional Budget Office (CBO) director Doug Elmendorf refuted the claim that the Affordable Care Act is a job killer – a misleading takeaway from his agency’s new report that is being touted by Obamacare critics….

….In fact, the CBO report explicitly states that the estimated reduction in labor “stems almost entirely from a net decline in the amount of labor that workers choose to supply, rather than from a net drop in businesses’ demand for labor” and that “there is no compelling evidence that part-time employment has increased as a result of ACA.” Those notions are further supported by economic data on full- and part-time employment trends over the last several years. Simply put, the report finds that Obamacare will reduce the number of people who are forced to work a job merely for the sake of health insurance….

Today, from Representative Vicky Hartzler (r), via Twitter:

Rep. Vicky Hartzler ‏@RepHartzler

In sobering Budget Comm.w/ CBO Dir. Projection: $10 trillion more to natl. debt, slow economy, and ACA causing loss of 2.5 million jobs. 9:26 AM – 5 Feb 2014

[emphasis added]

And that, of course, generated responses:

TQJ ‏@tqjones44

@RepHartzler Stop lying about job losses! 9:27 AM – 5 Feb 2014

Chet Coenen ‏@chetcoenen

@RepHartzler source your numbers? 9:28 AM – 5 Feb 2014

Alex ‏@aivanther

@RepHartzler I hate to say this, but you realize a trillion dollar farm Bill is part of the problem, right? 12:05 PM – 5 Feb 2014

For some reason, I just don’t think we’re going to see a lot of open public town halls in the 4th Congressional District before the 2014 general election.

By now you’ve probably read lots about State Rep. John Lamping’s (R-24) lame attempt to launch the latest Missouri Republican attack on Obamacare. If you haven’t, you’ll find a good description of the bill and the issues it involves in this write-up by Gloria Bilchik at Occasional Planet, while Blue Girl here at SMP puts Lamping’s legislative chops into perfect perspective – as in “I loathe scum like Lamping with every fiber of my being and can’t imagine what it must feel like to be so empty inside, so bereft of humanity and kindness, so meanspirited, venal and utterly contemptible, so vapid, insipid, petty and trite”. I’m pretty sure she disapproves.

Blue Girl also acknowledges something else we all know which is that this exercise in radical rightwingery hasn’t a ghost of a chance of passing in even our GOP-heavy legislature – there are actually a few constitutional realists among the GOP crazies in Jefferson City – or being signed by our reasonably sane Democratic Governor should the unthinkable occur. And the case against the legislation’s viability was further bolstered by a judicial decision handed down today by the U.S. District Court for the District of Columbia.

Lamping’s bill, SB546 (and companion House legislation introduced by  Rep. Keith Frederick (R-121), HB1314), was inspired by the Cato Institute’s Michael Cannon, who has encouraged lawsuits arguing based on the argument that the subsidies offered to low and middle income Americans on the federal exchange violate the law as it is written. As Ezra Klein notes:

The dispute settles around a single sentence: The Affordable Care Act’s defining a health insurance exchange, in Section 1311, as a “governmental agency or nonprofit entity that is established by a state.” Since the law says subsidies only go to people buying insurance “through an Exchange established by the State under 1311,” Cannon and some others argue that the federal exchanges, though specifically envisioned in the law, can’t receive subsidies.

Today’s verdict is the first to come down and it, tellingly, doesn’t endorse Cannon’s logic:

Judge Paul L. Friedman called that argument “unpersuasive,” saying it didn’t pass legal muster and ran counter to the central purpose of the Affordable Care Act.

“Plaintiffs’ proposed construction in this case – that tax credits are available only for those purchasing insurance from state-run Exchanges – runs counter to this central purpose of the ACA: to provide affordable health care to virtually all Americans,” Friedman wrote in a 39-page decision. “Such an interpretation would violate the basic rule of statutory construction that a court must interpret a statute in light of its history and purpose.”

His reasoning? The federal exchanges — which the Obama administration is constructing for 34 states that declined to build their own — “would have no customers, and no purpose” if the challengers’ logic were adopted.

Of course, this is just the first verdict in one of several lawsuits, but it doesn’t look too good for folks who think they’ve found the perfect, last-ditch, anti-Obamacare wriggle.

What this means in practical terms for Missouri progressives, as far as I’m concerned, is that John Lamping has given the state’s Democrats a big, fat, no-risk gift right before the mid-term elections. While Blue Girl notes that SB546 is “going nowhere, except in our file of stuff to use against the neoconfederates next election cycle,” we shouldn’t underestimate the good we can do with that file or just how potent this particular bit of GOP chicanery could prove to be when it comes to next fall’s elections.

At the end of December 33,138 Missourians or 5.04%  of the estimated eligible population had enrolled in private plans through the federal Website, Healthcare.gov. That number will undoubtedly grow massively in the next three months – in spite of statewide GOP efforts at obstruction – and, as the St. Louis Post-Dispatch noted about earlier numbers, many of these new enrollees will also be eligible for the subsidies that Lamping says he wants to take away.

Lamping must think he’s got a winner here, but if I were one of those folks getting acquainted with Obamacare via my first-time healthcare coverage and finally learning how empty the last three-years of GOP scare-tactics were, I wouldn’t feel too friendly toward jerks who were trying to make sure that I couldn’t afford to pay for it. It could be a relatively short jump from John Lamping to the entire Missouri GOP – particularly in view of their past, desperate anti-Obamacare rhetoric. We’ve just got to get the word out about who it is who doesn’t care if Missourians live or die.

3rd paragraph edited slightly for clarity: (see striken test), and for accuracy: “federal” added before exchange.

The Chair of the Missouri Republican Party, Ed Martin, has a problem with the reality that the rest of us inhabit. The proof? Read his oddly gloating statement about the Obamacare signup numbers that were released Monday. He starts cute:

The truth hurts; at least it hurts everyday Missourians and millions around the country. Another month of enrollment numbers brings another announcement from the Administration cloaking the colossal failure that is ObamaCare.

“The truth hurts”? Give me a break. Is Martin trying to say that the numbers aren’t accurate? If so, where’s his proof? Or is Martin really so dense that he  believes the fact that total enrollments doubled in December constitutes some type of failure? In fact, this new evidence that the early rollout hiccups are now in the past inspired The Wasington Post‘s Ezra Klein to announce that we’re seeing the “death of Obamacare’s death spiral,” – you, know, that “death spiral” that folks like Martin have been heralding for the last three months.

Seems to me that the main thing that the new numbers tell us is that lots of folks have managed to get healthcare coverage, many for the first time. But that type of success doesn’t concern Ed Martin:

No amount of repairs to a website, or new rules meant to shore up ObamaCare’s failed policy, will fix the problem the law created for countless Americans that lost theirs plans through no fault of their own.

And this is where the truth actually does hurt – only the wounded entity is Ed Martin’s credibility. As Patrick Caldwell notes in Mother Jones, the truth “turns out to be a tad more complicated” than the rote talking points of GOPers like Martin suggest:

… . On New Year’s Eve, the Democratic minority on the House Energy and Commerce Committee released a report examining exactly how many people will lack health insurance under the new regime. The report uses an Associated Press estimate that 4.7 million people received cancellation notices as their baseline. But out of that group, according to the Democrats, only a small sliver of Americans-just 10,000 people-who lost their 2013 coverage won’t have access to affordable insurance.

“Previous false claims have included the assertion that the law requires death panels, that the law represents a government take over of health care, and that law has caused millions to lose their jobs,” the report says. “The assertion that the law will cause five million individuals who currently have coverage in the individual market to go without coverage in 2014 is similarly baseless.”

But Martin’s got more: He’s sure that the risk pool among the new enrollees is so unbalanced it will bring the whole Obamacare edifice tumbling down:

By the White House’s own admission, the young and healthy will have to shoulder the burden of ObamaCare. Today’s numbers show young Americans are avoiding the mandate at a significant rate. The White House continues to hide key data points by refusing to release the number of Americans that have actually paid for plans selected through the federal marketplace. What are they hiding?

However, as Klein notes, Ed’s worries about the ratio of young enrollees to older, sicker folks is a tad premature:

But — and this can’t be emphasized enough — this is not the final risk pool. No one anywhere expected that the risk pool would be balanced by Jan. 1. Major health laws always follow the same pattern: The people who badly need insurance sign up first, and they tend to be older and sicker. Younger people sign up later — typically right before the penalty hits. So far, the age pattern in Obamacare enrollment is tracking the age pattern in enrollment for the Massachusetts reforms quite closely.

In fact, as Klein notes, it may take up to three years to sort out the risk pool to the point that we actually understand how well the system will function. At any rate, the current ratio of young to older enrollees is actually not, as it stands, an insurmountable problem according to Larry Levitt, Senior Vice-President of the Kaiser Foundation:

Even if the current mix of enrollees holds, Levitt does not foresee a shock to the insurance system, with only a potential 2 to 3 percent increase in premiums in 2015. “I see no signs at this point of a feared premium ‘death spiral,’ ” in which premiums skyrocket and the system collapses, he says.

Nor is the failure to tell us how many enrollees have paid for their plans a real issue. Just the teensy-tiniest bit of reflection might suggest that it’s a bit too early to get meaningful figures – many new enrollees haven’t even had time to receive billing statements. Perhaps Martin should dry his crocodile tears and ask again in a few months.

It’s Martin’s closing grace notes, however, that are really special:

When America judges this administration, when it’s all said and done, this law will undoubtedly be the downfall of a historic presidency.

Who’d of thought that Martin would be so worried about the legacy of the black man in the white house, the same guy who’s kept Martin and his co-partisans so lathered up during the last five years that they’ve clearly lost touch with the real world.

Tony Messenger, of the St. Louis Post-Dispatch, via Twitter today:

Tony Messenger ‏@tonymess

About 6 million more Americans have insurance today than they did in 2013. #Obamacare will never, ever be repealed. [….] 11:23 AM – 2 Jan 14

He linked to an article in The Atlantic:

….Only 10,000 people whose individual-market plans have been cancelled or slotted for cancellation under the Affordable Care Act will be unable to get affordable insurance going forward, according to a new report from Democrats on the House Committee on Energy and Commerce. That’s “0.2 percent of the oft-cited 5 million cancellations statistic,” The Plum Line noted. The vast majority should be eligible to stay on their existing plans, thanks to the administration’s last-minute fix to permit this, or get subsidies through the exchanges, according to the report. The rest should be able to obtain affordable catastrophic-care plans, according to the congressional staffers. Still, there are bound to be enough people who previously had something better among the nearly one million people the report says could at least get catastrophic care plans that concerns and objections will continue into the new year. But the specter of a massive increase in uninsurance due to the Affordable Care Act seems unwarranted, the report makes clear, because that projection fails to take into account the variety of insurance options now available.

That upset someone:

Gregg Keller ‏@RGreggKeller

@tonymess Alternate reading: 4M more dependent on govt. 2M enrolled in OCare. 5M forced off their existing coverage. 11:31 AM – 2 Jan 14

Tony Messenger responded:

Tony Messenger ‏@tonymess

@RGreggKeller Alternate reading: Republican consultant machine freaking out because good hair and “repeal Obamacare” is all they’ve got. 11:35 AM – 2 Jan 14

Game. Set. Match. Nothin’ but net.

We couldn’t help ourselves:

Michael Bersin ‏@MBersin

@tonymess Okay, now you’re just toying with them. #battleofwitswithunarmed 11:48 AM – 2 Jan 14

Where are the death panels? That’s a really good question:

January 02, 2014 9:51 AM

Where Is Obama Hiding the Death Panels?

By Ed Kilgore

….It’s long been understood that once ACA fully took effect, it would finally benefit from a significant number of beneficiaries-above all people locked out of health insurance because of preexisting conditions-with something tangible to lose from its repeal or evisceration. But it’s equally true that the non-materialization of some of the more lurid accusations about Obamacare will (or should) slowly sow some doubts about the law’s opponents.

I’m certain Representative Vicky Hartzler (r) and other republicans in the Missouri congressional delegation will get right on this.

Previously:

The republican controlled General Assembly can’t and won’t do the math (December 31, 2013)

Governor Jay Nixon (D) [file photo].

Yesterday, from the office of Governor Jay Nixon (D):

December 31, 2013

Gov. Nixon says Missouri should resolve in 2014 to strengthen and reform Medicaid, the Missouri way

JEFFERSON CITY, Mo. – Gov. Jay Nixon today addressed the media in Jefferson City on the importance of strengthening and reforming Medicaid the Missouri way. Below are his prepared remarks:

“Tomorrow, we will celebrate a New Year. And as we do every January 1, we’ll reflect on what we’ve done over the past 12 months, and contemplate what we resolve to accomplish in the year ahead.  

“But 2014 will be a little different. Tomorrow, 4.4 million Americans in states all across the nation – folks who are working, but don’t have health insurance – will wake up and be eligible to get the basic health care services they need.

“Tomorrow, roughly $37 billion – including two billion of Missourians’ tax dollars – will begin to flow to 25 states that are reforming and improving their health care systems. States like Arkansas and New Jersey, Iowa and New Mexico, Michigan and Ohio, Arizona and North Dakota.

“Tomorrow, businesses in these states will have a significant competitive advantage – because as more people get health coverage, fewer people show up in emergency rooms, putting downward pressure on private health premiums.  

“But not here in Missouri. Because of the legislature’s inaction on Medicaid, here in Missouri, 2014 will start in a different way.

“Tomorrow, nearly 300,000 working Missourians will continue to be uninsured.  They’re factory workers and house cleaners, mechanics and truck drivers, moms and dads. These folks work tough, low-paying jobs that don’t offer health benefits, and they can’t afford a doctor’s bill.

“Tomorrow, moms with breast cancer, dads with heart disease, young adults with mental illness, will go another day without the treatment they desperately need, for no other reason than they live in Branson instead of Bentonville, in Cape Girardeau instead of Cairo, Maryville instead of Muscatine.

“Tomorrow, Missouri families and businesses will continue to pay federal taxes, but instead of coming back to Missouri, those tax dollars will be spent in other states: $2 billion a year, $5 million every day.

“Tomorrow, employers in Missouri will face an uneven playing field – shouldering the burden of rising health premiums, while their competitors in other states see their costs go down.        

“Tomorrow, Missouri’s Medicaid system will operate as it has for years, without additional needed reforms, protections for taxpayers, or new measures to promote personal responsibility, many of which are being granted for the first time in states that are moving forward.

“Obviously, it doesn’t have to be this way. We’ve seen our neighbors in Arkansas, Illinois, Iowa and Kentucky move forward with common sense, market-based approaches to helping low-income working families afford the basic health care services they need to live healthy lives.

“Republicans and Democrats in these states worked together to stand up for taxpayers, for families and for their communities. They seized this opportunity to implement innovative reforms – like rewards for making healthier lifestyle choices and penalties for missing doctors’ appointments, or showing up at the emergency room with a stuffy nose.

“They’re using market-forces to modernize what had been outdated and inefficient health care systems, and improve outcomes and reduce costs for everyone. And unless we change course, they’re going to do all this with our tax dollars – while Missouri gets left behind.

“That’s wrong – and as we’ve seen in these other states, there’s a clear way to fix it.

“So as we begin the New Year, let’s resolve to work together to make Missouri a healthier place to live and work.

“Let’s resolve that Missourians who work hard day and night can afford to see a doctor when they are sick and to take medicine to help them get well.

“Let’s resolve that no Missourian should have to choose between going back to work and keeping their health insurance.

“Let’s resolve that Missourians’ tax dollars be spent here in Missouri, not in other states.

“And let’s resolve to pass a bill that brings our tax dollars home to strengthen and reform Medicaid the Missouri way.

“The stakes are high. The choice is clear. And time is running short. We can – we will – we must get this done this year.”

[emphasis added]

Anything has to go through the republican controlled Missouri General Assembly. Don’t hold your breath for anything useful. They have other priorities.