Examination, in each area, will consider the costs and benefits that affect those aside from providers and recipients of expansion. .
Medicaid Spending in Missouri.
In fiscal year 2012, Medicaid spending in Missouri totaled $8,726,534,192 (Kaiser Family Foundation, 2012a). The federal share of this spending was 64 percent or $5,584,981,883 and the state share was 36 percent or $3,141,552.309 (Kaiser Family Foundation, 2012b). If Missouri chooses expansion, as Governor Jay Nixon supports, his proposed 2015 budget "projects that expanding Medicaid will result in $77.3 million in general revenue savings " (National Association of State Budget Officers, 2014). Since federal funding will cover 100 percent of the costs through 2016 and then be reduced incrementally to 90 percent over the next four years, the Missouri budget summary indicates that "expanding access to our Medicaid system will infuse nearly $2 billion of additional federal funds into the economy of Missouri " (Missouri Budget, Fiscal Year 2015 Summary). .
Missouri is a net receiver of federal funds, meaning Missouri receives more money from the federal government than it pays in federal taxes. John Kiernan authored a report utilizing data obtained from the Internal Revenue Service, the Census Bureau, Transparency.gov, the US Department of Commerce - Bureau of Economic Analysis and the Bureau of Labor Statistics. This report measured the following three metrics for all 50 states and the District of Columbia; return on taxes paid to the federal government, federal funding as a percentage of state revenue and the percentage of a state's workforce that is employed by the federal government (Kiernan, 2014). In Fiscal Year 2012, Missouri received $1.05 in federal funding for every dollar paid in federal taxes and this funding represented 40.83 percent of the state's revenue (Kiernan, 2014). While ranking 16th in the tax return ratio, Missouri ranked 47th in federal funding as a percentage of revenue (Kiernan, 2014).
