JEFFERSON CITY, Mo. (AP) - Missouri Gov. Jay Nixon is continuing to push for a Medicaid expansion, but he's open to alternatives that could use federal money to buy private insurance for lower-income adults.
Nixon said in an interview Thursday that he's willing to consider an Arkansas model that would use Medicaid money to purchase policies through an online insurance exchange created under President Barack Obama's health care law.
The 2010 law called for states to expand Medicaid to adults earning up to 138 percent of poverty, or $32,500 for a family of four. A U.S. Supreme Court ruling last year made that optional for states.
Nixon is visiting Hermann and Perryville to build support for a Medicaid expansion. Republican legislators have rejected his plan. But Nixon says he hopes for a compromise.
The House sent the measure to the Senate Tuesday with a 116-41 vote.
Workers seeking to invoke the so-called conscience protection would have to provide reasonable notice.
The measure would also bar discrimination against all medical personnel for opting out of certain procedures or research. It would apply to abortions, sterilizations, embryonic stem-cell research, assisted reproduction and contraception. Hospitals, clinics and medical or nursing schools also could refuse to perform procedures that violate the institution's conscience.
Some Democrats who voted against the bill said it could negatively impact patient safety.
House members approved similar legislation last year.
Sponsors of the petitions must gather signatures from registered voters for their proposal to qualify for the ballot.
Under the House legislation, the secretary of state's office would offer a public comment period after a proposal is submitted. For those proposals that actually qualify for the ballot, the Joint Committee on Legislative Research would hold a public hearing.
The bill would also make it a misdemeanor to intimidate or obstruct someone who is trying to sign an initiative petition.
The House approved the measure Thursday on a vote of 151-3. It now moves to the state Senate.
Nixon said Thursday that the proposed one-half cent sales tax hike would be especially harmful to seniors and veterans on fixed incomes and also could also hurt working-class parents trying to provide for their children.
The bill given initial approval Wednesday night by the Republican-led Senate also includes a three-quarters of a percentage point decrease in the state income tax for individuals and businesses. That income tax cut would more than offset the sales tax hike, resulting in an estimated $450 million loss in state revenues once both tax changes are fully phased in.
The legislation needs another Senate vote before it can move to the House.
There are more than a dozen offices on the ballot, but the biggest contest is for Mayor. Mayor Slay is seeking his fourth term and is challenged by Lewis Reed, president of the Board of Aldermen.
The general election is April 2.
Organizers envision most of the convention taking place at the Sprint Center in downtown Kansas City. But say other events could be held at venues in the city's Kansas suburbs. The Republican convention was held in Kansas City in 1976.
House Speaker Michael Madigan has scheduled a hearing for Thursday. Lawmakers are expected to vote on pension changes he is proposing.
A provision among the changes calls for penalizing retirement before age 67 with reduced benefits.
Another measure requires employees hired after January 2011 to pay an additional 5 percent toward their pensions on top of other contributions.
Riverside Democratic state Rep. Michael Zalewski says the expected votes are intended to gauge lawmakers' support for some potential reforms.
Zalewski says there's been enough talk about the changes and now is the time for legislators to actually show where they stand.
The Senate's 27-7 vote Thursday sends the bill to the House, where it already faces some opposition.
House Speaker Tim Jones has said senators "over-reached" by significantly lowering the amount of tax credits available for the construction of low-income housing and the renovation of historic buildings. But Jones likes provisions in the Senate bill that create new tax credits for air cargo exports, computer data centers and investors in high-tech, start-up businesses.
Gov. Jay Nixon praised the bill Thursday for containing "long-overdue reforms" to tax credits.
A similar proposal to overhaul Missouri's tax credits failed during a 2011 special session.
Two separate House committees rejected the plan Monday. One shot down an attempt to add funding for a Medicaid expansion to the 2014 budget. Another panel defeated legislation that would have authorized the expansion of Medicaid coverage to an estimated 260,000 lower-income adults.
Both committees voted along party lines, with Republicans opposing the Medicaid expansion and Democrats supporting it. More than 30 people representing health care, business and social services groups testified in support of the proposed expansion.
The Medicaid expansion is called for by President Barack Obama's health care law and supported by Gov. Jay Nixon.
House Republicans are working on an alternative that may include a more modest expansion combined with cost-savings measures.
The Southeast Missourian reported that he earned 39 votes during his party's meeting in Poplar Bluff. De Soto funeral home director Todd Mahn got 27 votes, and former Blodgett mayor Markel Fitchpatrick earned only two votes.
Hodges, 64, of East Prairie, is a former grocery store owner and high school sports referee who spent a dozen years on a local school board and first won election to the Missouri House in 2006. Only after other likely candidates bowed out did he belatedly enter the race Wednesday night to run in a June 4 special election against Republican state Rep. Jason Smith, who was nominated by his party last weekend.
In accepting the nomination, Hodges recalled his son Andrew's valedictorian address at West Point. "He said opportunities sometimes only come along once in your life," Hodges said. "And he said it's your choice to decide whether to accept that opportunity or let it pass. I thought about it a great deal for several days this week and I thought I think God is presenting this as an opportunity for me. So I need to decide whether this is something I should take advantage of or let pass by because it's not going to happen again."
Missouri's 8th District stretches across 30 counties, from the outer suburbs of St. Louis south to the agricultural-base of the Missouri Bootheel and west to the rolling Ozark hills. The district's residents are the poorest and least educated in Missouri, with a median household income of less than $36,000 and more than 85 percent lacking bachelor's degrees. For 32 years, much of the area had been represented by either Bill Emerson or Jo Ann Emerson, who succeeded her husband after he died in 1996. Jo Ann Emerson resigned Jan. 22 to become president and CEO of the National Rural Electric Cooperative Association. Although of opposite political parties, Hodges praised the Emersons and vowed to continue their legacies of supporting labor and agriculture. He also stressed the need to balance the budget.
Hodges described Smith, the Republican nominee, as a friend and said he hoped to conduct the campaign as friends. "That was the way I was reared," he said. "But in politics as Gov. (Jay) Nixon has said, `There is no second place.' There are only winners and losers, and I hope to give you a winner."
Smith, an attorney, farmer and real estate partner, won a special election to the Missouri House of Representatives in November 2005. Because of term limits, Smith, 32, is now one of the most senior members of the chamber. After serving as majority party whip, his colleagues elected him in January as House speaker pro tem - the No. 2 ranking position.