MO State House Excludes Medicaid Expansion from Budget

Lily Bohlke

JEFFERSON CITY, Mo. -- Despite a majority of Missourians voting for Medicaid expansion in last year's elections, Republican state House lawmakers have dropped the $130 million to fund it from the state budget.

Under the Affordable Care Act, the federal government would fund 90% of the cost of expansion, roughly $1.4 billion, to cover between 200,000 and 300,000 residents who currently are uninsured.

Rep. Crystal Quade, D-Springfield, the House minority leader, said with the added incentive from the American Rescue Plan, about a billion extra dollars, there's no reason not to fully fund expansion.

And she pointed out as a constitutional amendment, regardless of whether the Legislature funds it, it's already state law.

"They would either cover the expanded population with less money or the department would then, at that point, choose to go back to the old population that was covered and essentially violate the state constitution," Quade explained.

Opponents of funding expansion say it costs too much, but Quade noted groups from the conservative Chamber of Commerce to the progressive

Missouri Budget Project say it would save the state money in the long term.

In last year's August primary elections, 53% of voters approved Medicaid expansion.

Quade contended they took matters into their own hands, after more than a decade of the Legislature refusing to cover the hundreds of thousands of residents who currently don't qualify for Medicaid, but who also can't afford marketplace insurance plans.

"We know the money exists, but also the voters have told us what to do," Quade asserted. "The state constitution is telling us that we need to be covering these folks."

She urged the state Senate to break from her House colleagues and fully fund expansion in the budget.

In a poll from the Missouri Hospital Association, 88% of respondents said the Legislature has a responsibility to implement changes approved by the voters.