JEFFERSON CITY, Mo. – When former Republican U.S. Sen. Kit Bond walks into legislative offices urging lawmakers to accept federal funds to expand the state’s Medicaid rolls, he’ll do so with a bit of baggage.

Last week, the Missouri Chamber of Commerce announced Bond – a former governor and U.S Senator who now runs a government relations firm – had joined their efforts to expand the state’s Medicaid rolls using federal funds. The chamber’s play with Bond’s hire was clear: Bring in a GOP elder to try to sway as many Republicans as possible behind expansion and reform.

But in just a few years, Bond has come a long way in terms of support for the policy. During an interview with the conservative website Newsmax in March 2010, Bond said the burdens of expansion on the state would be “horrific.”

“Most state budgets are strapped. States are fighting hard to deal with the budget shortfalls they have, and that Medicaid burden is another pail of water on drowning state budgets,” he said at the time.

Bond acknowledged his prior vocal opposition to the overall law in a statement last week. As recently as December, he called the law “a pile of manure.” But on Medicaid specifically, Bond said expansion was imperative for the bottom lines of rural hospitals.

“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,” he said.

The federal health care law slashes payments for uncompensated care, assuming many of those who would use it will be placed on the Medicaid rolls. Without the Medicaid money, 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.

Speaking with reporters on Monday, House Speaker Tim Jones – a Republican who has expressed his opposition to Medicaid expansion – said Bond’s endorsement of Medicaid expansion does not affect his position, noting that Bond has been hired to advocate.

“We all respect Senator Bond. He’s done great things,” Jones said. “Kit Bond was retained to advocate on behalf of this position. I’m sure he’ll advocate zealously for this position.”