Missouri House plan to reject Medicaid expansion faces uncertain fate in the Senate

The Missouri House floor for the 2019 State of the State address.
The Missouri House chambers during the 2019 State of the State address (photo courtesy of the Missouri Governors Office).

Republicans in the Missouri House finalized their plan to block funding for voter-approved Medicaid expansion on Thursday, giving final approval to its version of the state’s budget and sending it to the Senate.

What happens next remains unclear.

House Democratic Leader Crystal Quade said she’s confident the Senate will restore the $1.9 billion in Medicaid funding that Missouri Gov. Mike Parson included in his proposed budget.

And indeed, Sen. Lincoln Hough, a Springfield Republican and vice chair of the Senate Appropriations Committee, told the Springfield News-Leader on Wednesday that the Legislature has no other choice but to fund expansion. 

“It’s in the state constitution,” he said, “the voters approved it and we’re going to find a way to fund it.”

Senate Majority Leader Caleb Rowden, R-Columbia, said it’s far too early to tell what the Senate will ultimately do.

“We didn’t get into the issue with our caucus yet,” Rowden said. “We have a lot of conversations to have.”

Republicans are playing a “dangerous game” with people’s healthcare, said Senate Minority Leader John Rizzo, D-Independence.

“Time will tell if eight reasonable Republicans can be found to work with the Democrats to save the voter-approved Medicaid expansion in the Senate,” he said.

The House version of the budget is $2.2 billion below the proposal made in January by Parson, and the biggest difference is the absence of $1.9 billion for expanded Medicaid eligibility.

Parson’s budget estimated that 275,000 Missourians would be added to the Medicaid program after voters in August expanded eligibility to households with incomes below 138 percent of the federal poverty guideline — or about $17,775 annual for a single person and $36,570 per year for a family of four.

Under the American Rescue Plan, which was recently signed by President Joe Biden, states that have not expanded Medicaid get an incentive to do so which is worth around $1.15 billion for Missouri over the next two years.

“We did put the money in the budget for that,” Parson said in a recent interview with KDRO in Sedalia. “People did vote for it. Although I didn’t support it at the time, 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.”

Thursday’s budget debate in the House capped a contentious week, with Democrats once again excoriating Republicans for refusing to fund voter-approved expansion. 

Rep. Peter Merideth, D-St. Louis, called the GOP plan “disrespectful” to the voters of Missouri. 

“We swear an oath to the constitution,” Merideth said. “And we claim to come here to serve people based on our values. We talk about Christian values. Denying people healthcare is not a Christian value.”

Rep. Justin Hill, R-Lake Saint Louis, said House Republicans did “the absolute right thing” by refusing to fund expansion.