– A vocal critic of the 2010 federal health care law, former Republican U.S. Sen. Kit Bond has now joined the Missouri Chamber of Commerce in championing one of its biggest provisions: Medicaid expansion.

Following a report in the Kansas City Star, the Missouri Chamber announced they have enlisted the four-term U.S. Senator and two-term Missouri Governor to help lobby members of the General Assembly to reform and expand the health care program for the poor to adults.

“Republicans in the Missouri General Assembly are the ones that are the most hesitant about the expansion and there are few Republicans that are as respected as Sen. Bond,” Dan Mehan, Missouri Chamber president and CEO, said in a statement.

Bond, in a statement Friday afternoon, said he was still opposed to the federal health care law, but believes the state should not leave millions of dollars from the federal government on the table – particularly with the potential impact of reduced disproportionate share payments from the federal government to regional and rural hospitals.

“While I was and still am one of the loudest opponents of Obamacare, I’m getting involved in Medicaid reform now because if our state sits on the sidelines I’m concerned hospitals in rural and inner city Missouri won’t survive,” Bond said.

The federal health care law slashes payments for uncompensated care, assuming many of those who would use it are placed on the Medicaid rolls. Without the Medicaid expansion, which was ruled voluntary for states by the Supreme Court, the lack of coverage for uncompensated care leaves rural hospitals on the hook. Bond believes up to $208 million could be lost by the state by 2019.

The Missouri Chamber noted that Missouri could lose up to $2.2 billion by 2020 if it doesn’t expand the program. For the first three years (which has already begun), the federal government will cover 100 percent of the costs for Missouri, before shifting down to 90 percent by 2020.

Democratic Gov. Jay Nixon’s budget calls to accept federal funds to expand the state’s Medicaid rolls, and said it could actually save the state some $70 million this year because of shifting some costs currently paid by the state to the federal government.

But Republicans in the General Assembly have yet to budge. The issue is politically dangerous for them, as a handful of legislative leaders are considering Republican primaries for statewide office in 2016. House Speaker Tim Jones, one of those Republicans, has referred the issue to Rep. Jay Barnes, R-Jefferson City, who has worked on a plan that he believes could save the state money while all-the-while expanding the program.