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Missouri Politics

Lack of Missouri Medicaid expansion creates uncertainty for state, patients


Missouri Gov. Mike Parson's decision not to expand Medicaid eligibility creates uncertainty for the state and people needing medical care, experts and advocates said Thursday.

Gov. Mike Parson announced Thursday that Missouri will not expand Medicaid coverage to an estimated 275,000 low-income residents who were set to become eligible for the program July 1. Missouri voters in August approved a state constitutional amendment to expand the program, but Parson said the legislature did not fund the expansion, make it unconstitutional.

Parson’s budget proposed spending $14.1 billion for Medicaid, including $2.7 billion from state general revenue. Medicaid in Missouri cost $10.8 billion in fiscal 2020, about 4% more than the previous year.

Jim Layton, an attorney with Tueth Keeney, said the lawsuits challenging the state's decision not to open up eligibility could come after July 1 when someone applies for coverage under expanded eligibility and are then denied.

Layton said there are two sides of the state's defense, one being that the constitutional amendment was invalid because it didn't include a funding mechanism as well as the lack of federal approval needed for expansion.

Jake Hazelswerdt, professor in the Truman School of Government and Public Affairs at the University of Missouri, said whether the state does end up with expansion in the future or not, he believes the governor's decision to be consequential because it would delay implementation and potentially change what the expansion will look like when it does happen.

Democratic leaders say the governor's claims are disingenuous because money is available.

"There is more than enough money in the budget to implement expansion," said state Sen. John Rizzo, D-Kansas City. Rizzo said the governor has caved to authoritarians in the Republican Party and has violated his oath to uphold the state Constitution.

Rizzo said he expects expansion to happen once it makes it through the court system. "There's obviously some new Republican authoritarianism sweeping through this country to where they don't respect the outcome of elections," Rizzo said.

MO HealthNet has one of the nation's strictest eligibility rules. It does not cover most non-disabled adults without children. Parents are able to qualify if their household income is below 21% of the federal poverty line, which in 2021 was less than $5,000 a year for a family of three.

The expansion would have raised the eligibility to 138% of the federal poverty line or just below $18,000 a year.

Richard Von Glahn, policy director for Missouri Jobs with Justice, said he has heard for decades of situations where people have had to ration their insulin to be able to afford rent and utility bills.

Von Glahn said the expansion would create thousands of jobs in the health care field. "Jobs where people have been sacrificing so much over the last 14 months and putting their own lives and safety on the line to know that more support was coming since voters spoke last August," Von Glahn said.

Emily Kalmer with the American Cancer Society Cancer Action Network said cancer patients cannot wait for legal battles to access the life-saving coverage that Medicaid expansion provides. "This year alone, 37,390 will hear the words 'you have cancer' and 12,960 Missourians will pass away from cancer. None of them should suffer a day without the health care that over 670,000 Missourians voted into the Missouri Constitution," said Kalmer.

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Chanel Porter

Chanel joined ABC 17 News in January 2021 after graduating from Penn State University. She enjoys traveling and a daily iced coffee.


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