MM Curator summary
MO Medicaid expansion funding was not included in the house appropriations package.
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The Missouri House has passed the next state operating budget – without funding voter-approved Medicaid expansion. The $34.1 billion budget plan is now in the hands of the Republican-controlled Senate. Missouri Senate President Dave Schatz, R-Sullivan, gives his thoughts to Missourinet affiliate KTUI in Sullivan about whether he expects the upper chamber to fund the expansion.
Missouri Senate President Pro Tem Dave Schatz speaks to Capitol reporters on November 8, 2018 (photo courtesy of Harrison Sweazea at Senate Communications)
“The House chose not to fund it. I think it’s likely that the Senate does not put it in the budget as far as funding Medicaid and it will be up to, at that point, to see what the courts say. I believe we have the Constitutional grounds to stand behind the decisions because we are the appropriators of money. We’ll see where it goes,” Schatz tells KTUI. “But I think, again, it’ll remain up to the will of the Senate of the 34 members as to whether or not we do put it in. If some sort of funding mechanism goes in there, then obviously the House and Senate would have to get together, conference on that item and see if there’s a compromise there in order to do it. But I mean it’s likely right now if the House didn’t send it over in there, I believe it’s likely that the Senate, it’s probably not in there as well.”
Last August, 53% of Missouri voters approved providing government-funded health care coverage to about 275,000 low-income adults, although it failed in 105 of the state’s 114 counties.
Under the expansion, 90% of the funding comes from the federal government. Missouri picks up the rest of the tab.
“The one thing that it did not include in it was a funding mechanism,” says Schatz. “Therefore, obviously all it did was expand the Medicaid population to 138% of the poverty level. I truly believe, had there been something in there that said, ‘Oh and by the way, we are going to increase this tax or that tax in order to pay for this program,’ I don’t think that measure passes.”
Gov. Mike Parson, a fellow Republican, requested $1.9 billion to fund the expansion set to begin in July. Parson did not back the expansion ballot measure but has said he will implement it. Here is what Parson has to say about the GOP-controlled House’s effort.
“We’ll have to see how that goes in the Senate there. We did put the money in the budget for that. People did vote for it. Although I didn’t support it (expansion) at the time but the reality of it is, the people of the state voted for it. I thought it was my obligation as governor to make sure we try to get it implemented,” Parson tells Missourinet affiliate KDRO in Sedalia. “We’ll see though. The House voted against that – a little different maneuver I want to say, I guess. We’ll see what the Senate does and we’ll see how it comes out at the end of the day.”
The Legislature could choose to use the governor’s request for the expansion to instead help seniors in nursing homes, the developmentally disabled, expand mental health programs, add more public defenders, and for K-12 public school transportation costs.
In excerpts from a statement from Missouri House Minority Leader Crystal Quade, D-Springfield, she says Republicans need to stop with the political grandstanding and games.
“The only thing House Republicans have done is declare they would rather bankrupt the state Medicaid program than respect the clear will of the voters and fulfill their most basic oath to follow the constitution. They would rather cling to extreme partisan dogma that holds our state back than accept the tremendous economic and public health benefits expansion will provide. This fight is so unnecessary and little more than a destructive temper tantrum by petulant children who didn’t get their way,” says Quade. “So, after expansion takes effect three months from now and more Missourians enroll, the program at some point will run out of spending authority if House Republicans are successful in defunding Medicaid in the final state budget. That will require the legislature to return for a costly special session to pass a supplemental budget bill to fund Medicaid for the full year. And if Republicans refuse to provide full funding in a supplemental, then the battle will shift to the judicial branch, where it inevitably ends with a court ordering Republicans to comply with the constitution. Every medical organization and patient advocacy group in the state supports expansion. Even the Missouri Chamber of Commerce – as Republican of a group as there is – supports expansion.”
The state Constitution requires the Missouri Legislature to approve a balanced budget by early May.