MM Curator summary
The expansion category is now active, but there still have been no state funds appropriated to cover the additional enrollment or the additional state staff work needed to implement.
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After more than a year of pushback and legal barriers, individuals in Missouri can now apply for coverage under the state’s Medicaid expansion amendment.
Source: Getty Images
October 05, 2021 – Following Missouri’s approval for Medicaid expansion, more than 275,000 individuals are eligible for healthcare coverage, CMS reported.
Missouri will receive around $968 million from the American Rescue Plan over the next two years to fund the expansion. In order to encourage Medicaid expansion, the American Rescue Plan offers states a five percent increase to their original federal matching rate for services for two years.
States that enroll in Medicaid expansion also receive 90 percent matching funds for medical services through the Affordable Care Act.
“Hundreds of thousands of Missourians can now gain the peace of mind of having health coverage through Medicaid,” HHS Secretary Xavier Becerra stated in the press release. “This is a win for all Missourians who have fought long and hard to gain their rightful access to quality health insurance made possible through the Affordable Care Act.”
Missouri’s Medicaid program, MO HealthNet, started accepting applications for Medicaid expansion coverage in August 2021. Since then, more than 17,000 individuals have applied. The expansion offers coverage for primary and preventive care, substance use disorder treatment, prescription drugs, and emergency services, the press release noted.
Medicaid coverage is now available to even more low-income individuals in Missouri. An individual who makes up to around $17,000 per year or a four-person family that makes up to $36,750 per year may qualify for MO HealthNet following the expansion.
So far, 38 states—including Missouri and the District of Columbia—have passed Medicaid expansion, contributing to the more than 80 million individuals who receive healthcare coverage from Medicaid and the Children’s Health Insurance Program (CHIP).
Twelve states have yet to expand their Medicaid programs.
“As we celebrate Missouri’s Medicaid expansion, the Biden-Harris Administration will double down on our outreach efforts to urge the remaining twelve states to join the rest of the nation in ensuring access to health care during this critical time,” Becerra added.
States that have expanded their Medicaid programs have seen reduced uninsurance rates and lower state Medicaid spending, according to a report from the Menges Group.
Missouri first passed its Medicaid expansion amendment in August 2020, during the COVID-19 pandemic. The expansion guidelines offered coverage to individuals between ages 19 and 65 whose income is up to 138 percent of the federal poverty level.
Those who supported the amendment said that expansion would help Missourians who did not have employer-sponsored health plans and it would reduce high healthcare spending by offering better preventive care access to low-income residents.
Opponents, including Missouri’s state treasurer Scott Fitzpatrick, said the expansion was not financially feasible, especially with the financial strain of the pandemic.
Despite two lawsuits against it, the state passed the amendment. The expansion was set to go into effect on July 1, 2021, but another court ruling put enactment on hold in June 2021.
MO HealthNet withdrew the amendment, citing that the initiative petition was unconstitutional and could not require the General Assembly to provide funds for its operation.
The Medicaid program indicated that the state did not have the funds to pay for the expansion and the General Assembly did not budget for the funding, leading MO Healthnet to withdraw the plan. The circuit court sided with the state.
However, the Missouri Supreme Court overturned the ruling, sending the case back to the Cole County Circuit Court.
On August 10, 2021, the court ordered that the state could resume Medicaid expansion. Missouri’s governor Mike Parson included funding to cover the additional healthcare costs for newly eligible enrollees in his FY 22 budget proposal, but the funds were not included in the final budget.
MO HealthNet will have to leverage existing employees and funds to assist with applications, the governor’s press release noted.