Missouri�s sluggish economy and lagging employment in the health care industry are direct results of the state legislature�s refusal to accept federal dollars to expand the state�s Medicaid program, Gov. Jay Nixon said yesterday.

Nixon issued a statement that reacted to a report released Friday by the Missouri Economic Research and Information Center, or MERIC, showing health care job growth in Missouri is falling behind the states that have accepted federal money for Medicaid expansion.

The Republican-dominated General Assembly has repeatedly rebuffed Nixon�s calls to expand the Medicaid program, although a handful of GOP lawmakers have warmed to the idea and even tried to present a Medicaid expansion bill in the final days of this year�s legislation session.

Rep. Jay Barnes, R-Jefferson City, is one of the GOP�s Medicaid expansion advocates, but he said this morning that less-than-expected economic growth is not related to the absence of Medicaid expansion.

Barnes and other lawmakers were still smarting over the governor�s decision yesterday to withhold more than $1 billion total � including more than $780 million from general revenue � from the legislature�s approved budget.

Nixon, meanwhile, said the MERIC report was �more stark and troubling evidence� that the state�s economy was �suffering the consequences of the legislature�s irresponsible inaction on Medicaid.� He said health care should be the fastest growing part of the state�s economy but is instead �losing steam,� citing job losses for some health care providers.

Chesterfield-based Mercy Hospitals, the sixth-largest Catholic health care system in the country, announced June 16 that it was eliminating 220 positions across the company, including 125 workers in the St. Louis area. The eliminated jobs are not related to patient care, Mercy officials said.

When Mercy officials announced a system-wide job restructuring earlier this month, spokeswoman Barb Meyer said the lack of Medicaid expansion � and the anticipated influx of new patients � was one reason for the layoffs.

BJC HealthCare President and CEO Steven Lipstein told Boone Hospital Center trustees earlier this year that the Affordable Care Act, or Obamacare, was among recent laws that had led to shrinking hospital revenues. The ACA, which called for states to expand Medicaid, was designed to help an estimated 30 million people gain health insurance.

Under the Affordable Care Act, passed in 2010, states may accept federal support to expand Medicaid to cover working adults who earn up to 138 percent of the federal poverty guideline.

Missouri was one of 24 states that opted out of the expansion.

Supporters say expanding Medicaid would provide coverage to an estimated 300,000 additional Missourians.

According to MERIC, expanding and reforming Medicaid would result in the creation of 23,868 jobs, $9.9 billion in new wages and $14.6 billion in new Gross State Product (GSP) from 2015 to 2022. According to the report, Medicaid expansion would also generate $402 million in new state general revenue from 2015 to 2022, including $53 million in new general revenue in 2015 alone.