Missouri Medicaid Expansion for 275K on Hold After Measure Not Funded by Legislature

Missouri Governor Mike Parson dropped the plan to expand Missouri's Medicaid health care program to thousands of low-income adults on Thursday, the Associated Press reported. The state's Republican-led Legislature decided to refuse funding for the voter-approved measure, noted that it wasn't in the budget.

"Without a revenue source of source or funding authority from the General Assembly, we are unable to proceed with the expansion at this time and must withdraw our State Plan Amendments to ensure Missouri's existing MO HealthNet program remains solvent," Parson said.

The constitutional amendment did not change existing eligibility standards for children and seniors, and it did not say how to pay for the expansion that is projected to cover about 275,000 people.

The decision sparked debate as Democratic lawmakers criticized the decision. House Minority Leader Crystal Quade claimed Parson wasn't upholding the constitution. Senate Minority Leader John Rizzo said Parson was "caving to the new authoritarian Republican regime that doesn't respect the outcome of elections."

For more reporting from the Associated Press, see below.

Missouri Governor Drops Medicaid Expansion
Governor Mike Parson delivers the State of the State address as Lt. Governor Mike Kehoe (right) listens on January 27, 2021, in Jefferson City, Missouri. Parson dropped plans Thursday to expand the state's Medicaid health care program to thousands of low-income adults after the Republican-led Legislature refused to provide funding for the voter-approved measure. Jeff Roberson/Associated Press

Parson noted that the state's $35 billion budget approved by lawmakers last week didn't provide the funding he had requested for an expansion of Medicaid, which is known is Missouri as MO HealthNet.

"This is going to end up in court—the governor knows it's going to end up in court," said Richard von Glahn, policy director for Missouri Jobs With Justice, one of the organization supporting Medicaid expansion.

Missouri Hospital Association spokesman Dave Dillon expressed disappointment over Parson's decision and said the association would coordinate with other Medicaid expansion supporters about the best way to proceed with litigation.

Though the federal government would fund the vast majority of a Medicaid expansion, some Republican lawmakers said the state cannot afford its share of the long-term costs under the terms of a law signed by President Barack Obama in 2010.

The amendment passed by voters required Parson's administration to submit a plan to federal officials to expand Medicaid by March 1, which he did. The ballot measure stated that people ages 19 to 65 earning up to 138% of the federal poverty level—less than $17,774 annually for an individual or less than $37,570 for a family of four—"shall be eligible" and "shall receive coverage" for Medicaid benefits starting July 1.

Parson had opposed Medicaid expansion at the ballot box, but he said he would uphold the will of voters and so included $1.9 billion in federal and state funding for it in the budget he proposed to lawmakers earlier this year.

Although the Legislature didn't include specific funding for the expansion, Democrats and some health care advocates contend the additional low-income adults could be covered from the general pool of funds that was allotted for Medicaid.

"Cancer patients cannot wait for legal battles to access the life-saving coverage that Medicaid expansion provides," said Emily Kalmer, the Missouri government relations director for the society's Cancer Action Network.

Missouri Gov. Mike Parson Press Conference
Governor Mike Parson listens to a question during a press conference on May 29, 2019, in Jefferson City, Missouri. Jacob Moscovitch/Getty Images