Hospitals have teamed up with the Missouri Chamber of Commerce and Industry to support an expansion of Medicaid eligibility to thousands of lower-income adults, which would bring in billions of additional federal dollars under the terms of President Barack Obama's health care law.
They contend that the additional federal Medicaid money is needed stabilize the hospitals' finances.
Chamber President and CEO Dan Mehan said the hospital job reductions are the start of "a very real and dire trend."
"We're starting to see medical deserts created in parts of the state," added Herb Kuhn, president and CEO of the hospital association.
Missouri has 155 hospitals. The state association surveyed 118 full-service, acute-care facilities and received responses from 84 of them. Of those, 41 had eliminated the equivalent of 998 full-time positions and 49 hospitals had implemented a hiring freeze affecting the equivalent of 2,145 full-time positions.
Those eliminated or frozen positions amount to about 2.5 percent of the roughly 126,000 full-time-equivalent hospital jobs in Missouri.
The survey found that 37 hospitals, including 26 from rural areas, were delaying or canceling capital investments totaling more than $100 million.
Mehan said Wednesday that "quiet momentum" is building among lawmakers for a Medicaid expansion plan that would be paired with other changes that would make the program more similar to private-sector insurance.
But many Republicans remain opposed to it. On Wednesday, several GOP senators again took to the Senate floor to express their firm opposition to any Medicaid expansion.
Senate Appropriations Committee Chairman Kurt Schaefer, R-Columbia, said the offer of extra federal money in exchange for Medicaid expansion would have a "heroin effect" — hooking the state and making it hard to quit the enlarged program if costs rise too high. He said he expects the state's share of an expanded Medicaid program to rise to over $1 billion a decade from now. He said that would limit the money available for other government programs.
"There is no way to do it without devastating what we spend on public education," Schaefer said.