Mo. lawmakers: Funding fight over voter-approved Medicaid expansion likely heading to court


JEFFERSON CITY, Mo. – Missouri’s governor and voters who approved Medicaid expansion in August are now depending on the Senate to fund expansion.

Starting July 1, those that make less than $18,000 a year are eligible to apply for Medicaid after voters approved the measure on the August ballot.

Last week, the House approved the state’s budget without funding expansion, so now it’s up to the Senate to put it back in.

“This Medicaid debate is going to get real; it’s going to get very real very quickly,” Senate Minority Floor Leader John Rizzo (D-Kansas City) said. “I have been inundated with phone calls from organizations and different groups and constituents when the House did not put it into the budget.”

Back in August, 53 % of voters in Missouri approved to expand Medicaid, but Republicans say voters weren’t told how it was going to be funded.

“I think if voters had the opportunity to choose, given all the information, I don’t think they would have overwhelming passed Medicaid expansion because the cost would have to come from somewhere,” Senate President Pro Temp Dave Schatz (R-Sullivan) said. “I was a strong advocate against Medicaid expansion.

The House passed the state’s nearly $35 billion budget before Easter without funding Medicaid expansion.

“Why are they putting us in a position to have to fight for something the people voted for?” Rizzo said. “We didn’t see this when they passed medical marijuana, I mean why this?”

It’s now up to the Senate if the voter-approved measure is added back into the state’s budget.

“I don’t think it’s a red or blue issue,” Rizzo said. “Donald Trump won this state overwhelmingly and they also voted to expand Medicaid.”

Senate Republicans say they are prepared for the courts to get involved if they don’t fund it.

“I believe that we are appropriators, the General Assembly are the appropriators and I think the courts will ultimately weigh in on this and I think we will probably prevail,” Schatz said.

“I think it’s certainly in the bounds of a court to tell the legislature via the amendment that was passed that you have to allow anybody under 138 percent federal poverty to enter into the Medicaid program,” Senate Majority Floor Leader Caleb Rowden, (R-Columbia) said. “The mechanism for the court to take funds from point A to point B as it relates to the legislature would be a gross violation of the separation of power.”

Originally, the House Budget Committee Chairman Rep. Cody Smith (R-Carthage) said it would cost $1.6 billion to fund the expansion, but less than $130 million would come from state funds.

“That’s the biggest concern we have right now, is how do we fund it into the future and so without a funding mechanism that’s dedicated to us, I’m not sure if we’re prepared to go down that path,” Schatz said. “If you’re going to saddle state government with a financial obligation, they need to be finding out a way to pay for it.”

Rowden said he hopes the initiative petition process, how Medicaid expansion was put on the ballot, changes.

“Any group of people with the property amount of money could put anything on the ballot that has no regard whatsoever of the future liability financially is fairly dangerous precedent,” Rowden said.

Currently, there is legislation making its way through the General Assembly making it harder to get an amendment on the ballot by increasing the fees.

Senate Democrats said they are ready to fight for voters.

“If it’s not in the budget, I anticipate a very lengthy discussion on the floor about why we are not responding to the voters’ wishes,” Rizzo said. “This is something the voters approved, it’s a constitutional right at this point by the state of Missouri. We all take an oath to uphold the constitution and not funding it to the fullest is, in my opinion, not keeping your oath.”

This expansion will allow an additional 275,000 people to be eligible starting July 1.

Recently, Gov. Mike Parson said he is depending on the Senate after he included funding for expansion in his budget request to lawmakers.

Rowden said the Senate Appropriation Committee has started the process of going through the budget the House passed, but he said the Senate is a week or two away from debate.

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