Program eligibility to expand beginning July 1
The Missouri Senate holds the fate of the state’s Medicaid expansion funding in its hands, as House Republicans took a stance against the expansion by removing its funding from the upcoming fiscal year’s general budget, arguing that there’s no money for it.
But that’s just not true, according to Amy Blouin — who founded the Missouri Budget Project in 2003 and serves as its president and CEO. She said other states which have already expanded Medicaid under the Affordable Care Act have provided data on how it’s played out financially for their budgets.
“And all of the states are seeing savings in their state general revenue costs and increased tax revenues just because of the influx of federal funds to the state to support the health care industry. Those two things…resulted in Medicaid expansion paying for itself. We fundamentally believe, and what the other cities are showing us is, that there really is not a state cost of Medicaid expansion,” she said.
State senators will either choose to vote on Missouri Gov. Mike Parson’s version of the state budget, which includes the approximately $130 million in funding for Medicaid expansion, or the House’s version, which does not.
“This is going to sound a little weird, but it’s a little too early to say [what will happen] and I think there are a good number of Republican senators in the Senate who support it and can join with Democrats to support it,” Blouin said. “So, I feel hopeful but not certain.”
Richard von Glahn, policy director at Missouri Jobs with Justice, said if they pass Parson’s version then Congress will almost certainly hold a conference committee — where members from both the majority and minority parties in both the Senate and House convene to hash out the differences and come up with a solution.
“The budget always has conference committees,” he said of the process, noting those conference committees are normally on issues that are not quite as significant as this one.
Missouri Sen. Karla May, D-St. Louis, serves on the Senate’s Appropriations Committee, which is tasked with drafting the Senate’s version of the state’s multi-billion dollar operating budget for the next fiscal year.
She said the votes on funding essentially equated to political football.
“The only thing we’ve been hearing is that there is not enough funding to expand Medicaid or the costs,” she said. “But that’s not true. This is the federal taxpayers’ dollars coming back to work for them, that’s what it is.”
Under the Affordable Care Act, the federal government will fund 90 percent of a state’s Medicaid expansion costs. The expansion makes it so that people who make around 138 percent of the federal poverty level or less are eligible — a higher threshold than Missouri’s previous requirements.
In addition, Blouin said, there are incentives for states that haven’t expanded which would provide additional funding to the state of Missouri of about $1.15 billion over the next two years to support the existing Medicaid program — well over the approximately $130 million in state money needed now to fund the expansion.
“So, what that means is that increases federal funds for our existing Medicaid population and we can reduce our state costs for the existing Medicaid population, which essentially frees up state general revenue that can be used for other critical services,” Blouin said.
In addition, the state should receive about $2.8 billion in American Rescue Plan Act funding from the federal government.
“So the state has plenty of money,” she said. “It’s just interesting then that their argument is that the state doesn’t have money and that’s why they’re resisting the will of the voters at this point.”
House Budget Committee Chairman Cody Smith, R-Carthage, segregated Medicaid expansion funding in a separate bill before the committee voted on the fiscal year state budget — a move seen by Democrats as a way to defund the expansion.
“The federal government has no money,”Smith told CapRadio, the NPR affiliate in Northern California. “There was only taxpayer dollars. They are federal deficit spending at a rate that’s unprecedented at this point, and we stand at a precipice.”
Missouri residents passed Amendment 2, a statewide vote to expand Medicaid health coverage, with 53.25 percent of voters in the August 4 primary casting their ballot in favor of the amendment. By lowering requirement thresholds for Medicaid beginning July 1, an additional 275,000 Missourians who struggle to make ends meet will have access to health coverage.
Because it is now part of the state’s constitution, critics of House Republicans have said that by refusing to include the funding, the representatives are rejecting the will of the voters — their constituents.
For now, von Glahn advises those waiting to receive health care under the expansion to move forward as planned.
“So, I think the first thing that [people] should know is eligibility is going up on July 1,” he said. “If they’ve been in the Medicaid gap, if they’ve been one of the 250,000 Missourians in the Medicaid gap, someone in their family has been, they should still plan to enroll on July 1. What the legislature is doing is needlessly causing confusion for people who’ve been suffering far too long.”