Missouri House refuses to fund voter-approved Medicaid expansion; Senate could still fund the measure


JEFFERSON CITY, Mo. – After the Missouri House decided not to fund Medicaid expansion, the House Budget Committee plans to spend that money elsewhere.

Gov. Mike Parson has previously said he is depending on the Senate to add expansion back into the state budget. Parson, along with House Democrats and voters who approved the measure, are also waiting for expansion, which takes effect July 1, to be funded. Instead, representatives are planning to spend the money on other state agencies.

“I think this body has clearly chosen not to expand Medicaid,” House Budget Committee Chairman Cody Smith (R-Carthage) said Thursday. “We disagree that expansion can happen without an express appropriation, that does not exist in the House budget.”

Back in August, 53% of Missouri voters approved the expansion, allowing an additional 275,000 Missourians to become eligible for Medicaid later this year.

“Folks in the expansion population shall be eligible for medical assistance under MO HealthNet and shall receive coverage for the health benefits service package,” Rep. Peter Merideth (R-St. Louis) said on the House floor. “The budget chairman is going to tell you that we can just not expand if we don’t fund that portion of the program.”

Earlier this month, the House approved the state’s nearly $35 billion budget without funding expansion, even though the governor’s budget request to lawmakers had Medicaid expansion in it. House Democrats tried multiple times to add expansion back into the budget on the House floor but were denied every time.

“This decision by the chamber not to fund expansion is not about protecting these vulnerable populations, it puts them in greater jeopardy,” Merideth said. “It is going forward because they don’t have the choice of it not to, no matter what we do in here.”

Republicans in the House argued Missouri voters were not told how expansion would be funded and believe if they had the chance to vote again, it would be voted down.

“If they wanted funds for this special interest program, they should have given us a funding source in the (Missouri) Constitution,” Rep. Justin Hill (R-Lake St. Louis) said. “The people that need these resources the most are going to suffer under expanded Medicaid.”

Originally, Smith said expansion would cost $1.6 billion with most of the money coming from the federal government. The House passed House Bill 21 Thursday, which uses the funds that were supposed to go to Medicaid expansion on other state agencies. The legislation breaks down how the state would spend $342 million, with $18 million going to K-12 school transportation, $2 million to adult high schools, $88 million to nursing homes, and $35 million in Medicaid reimbursements.

Another agency that would receive money is Missouri’s Office of State Public Defenders for the public defender system. More than $1 million would help the department hire 15 additional attorneys for parole.

“We continue to have those discussions and continue to try and gauge the will of our caucus, I don’t believe everybody probably agrees exactly where we should be,” Senate Majority Floor Leader Caleb Rowden (R-Columbia) said. “We’ll pass a budget and do what we need to do to make sure that happens.”

The state budget is now in the hands of the Senate, who could add expansion back in and if it’s added back, it could send lawmakers to conference to find a compromise.

“I think that’s more important, that’s the bigger reason why we should do it on this side because if we implement it, then it is a conference-able item,” Senate Minority Floor Leader John Rizzo (D-Kansas City) said. “Then we can make arguments of why it’s important to keep it versus having to work the other way around.”

The Senate plans to discuss the budget in Appropriations Committee within the next week. The vice-chairman of the committee, Sen. Lincoln Hough (R-Springfield), said there have been ongoing discussions about adding Medicaid expansion back into the budget.

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