Last August, Missouri voters narrowly approved expanding Medicaid. Last week, members of the House Budget Committee said screw the election results.
If you thought the fight to expand Medicaid — the federal program that provides health coverage to eligible low-income adults, children, the elderly, pregnant women and people with disabilities — was settled at the ballot box, think again.
In Missouri, elections don’t matter — at least not to some Republican lawmakers who are willing to undercut the central institution of democracy in the name of partisan dogma.
Voters approved a Medicaid expansion bill, Amendment 2, by 53 percent last year. The measure changed Missouri’s Constitution to require coverage for residents between the ages of 19 and 64 with an income level at or below 133 percent of the federal poverty level.
It expanded coverage to approximately 275,000 Missourians with annual incomes up to $17,744 for an individual and $35,670 for a family of four.
The Medicaid insurance program is funded jointly by states and the federal government. The feds pick up the majority of the costs.
The GOP-led budget committee voted against a $128 million spending bill that was included in Gov. Parson’s $34 billion budget, which would have funded the state’s portion of the Medicaid expansion.
The message was clear: This battle isn’t over. Voters may have approved Medicaid expansion, but we aren’t going to fund it.
Missouri Budget Committee Chairman Cody Smith, R-Carthage, said stripping Medicaid funding out of Parson’s budget will save the state money it doesn’t have.
“By standing up to liberal special interest groups, House Republicans have saved Missourians over $100 million in general revenue in the upcoming fiscal year alone and billions more in years to come,” Smith told reporters.
Smith and his GOP cohorts stood tall against groups like the Missouri Chamber of Commerce, the Missouri Hospital Association and various Christian organizations such as the Catholic Church who all advocated for Amendment 2’s passage on economic or moral grounds.
The notion the state doesn’t have the money to fund an expansion of Medicaid is pure bunk. The state is flush with cash thanks to federal emergency stimulus money. Missouri has a record budget surplus in the general revenue fund, which stood at $1.9 billion on March 1 and is expected to have $1.1 billion unspent at the end of the fiscal year, according to the Missouri Independent.
Expanding Medicaid in Missouri would cost about $1.6 billion, according to the budget bill. Of that, only about $103 million would come from the state’s general revenue. More than $1.4 billion would come from the federal government.
But the reason business groups and hospitals pushed for expanding Medicaid is because it is the fiscally responsible thing to do.
Studies and other states’ experiences demonstrate it would actually save the state money over the long run because it allows states to reduce spending on its traditional Medicaid program. And that’s critical because studies show Missouri’s Medicaid program is financially unsustainable and not meeting the needs of many people in communities who really depend on it.
Hospital groups support expansion because it would lower their costs from so-called bad debt or the costs of caring for poor people who show up at hospitals and get treatment and then can’t pay their bills. Those costs are ultimately passed on to the public in the form of higher insurance premiums.
These are hardly liberal arguments. The state has the money. The voters have spoken. To ignore the election results is anti-democratic.
The GOP’s actions in this matter will likely result in needless and wasteful litigation.
It’s no wonder why so many Americans are disgusted and disillusioned by politics.