Missourians to House: Fund Medicaid expansion as voters ordered

(The Center Square) – An overwhelming majority of Missouri voters, including Republicans, say the state’s GOP-controlled Legislature should expand Medicaid as voters instructed them to do when they adopted Amendment 2 in August.

That’s noteworthy since the Missouri House last week rejected a bill implementing Medicaid expansion claiming they are executing the will of the people.

But if the results of a January survey of 800 Missouri voters is indicative, that’s nowhere near true.

According to a poll conducted by opinion research firm American Viewpoint on behalf of the Missouri Health Care Association (MHCA), 88 percent of respondents said it was the Legislature’s “duty” to implement Amendment 2 as approved by the people. Only 8 percent said otherwise.

Additionally, 81 percent said it was the Legislature’s responsibility to implement the expansion “fully” to an estimated 275,000 low-income adults, as approved by voters under Amendment 2.

“What we see is very strong support for the implementation of the expansion,” American Viewpoint President Randall Gutermuth told the Missouri Times.

MHCA nor American Viewpoint have published all survey data but its breakout notes 45 percent of respondents were Republicans who voted against the measure in August. Of those, 56 percent said they’d vote “yes” now.

According to the survey, 45 percent said the General Assembly’s obligation to create a balanced budget overrode new requirements added by the ballot measure. Nearly 39 percent disagreed.

Eighteen percent “of those who actually voted no on Amendment 2 still think the legislature should uphold the will of the voters,” Gutermuth said. “That, in itself, should be telling.”

House Republicans threw a wrench into implementing the plan Thursday when the chamber’s Budget Committee in a partisan 20-9 vote shot down House Bill 20, which sought to allocate $130 million in general revenue to secure $1.9 billion in federal funding to pay for expansion.

The bill, crafted by House Budget Chair Rep. Cody Smith, R-Carthage, does not have a Senate companion and could be back when the House deliberates on Gov. Mike Parson’s $34.1 billion budget request this week.

Smith, as he did while campaigning against Amendment 2 and after it was adopted, reiterated the program is too costly. Opponents also argue the Missouri Constitution prohibits initiatives that require new appropriations without also providing a source of money.

Republicans contend in not funding Medicaid expansion, they would be executing the will of the people who voted for something they didn’t understand.

“If they had drafted (ballot language) including what the constitution actually requires, it may not have gotten over that 50 percent mark,” said Rep. David Evans, R-West Plains.

House Minority Leader Crystal Quade, D-Springfield, and other Democrats reminded Republicans in a Monday news conference that the state must expand Medicaid by July 1 without or without an implementing bill and that their actions are politically motivated antics.

Almost 1 million people are currently covered by Missouri’s Medicaid program. Amendment 2 requires the state to offer coverage to approximately 275,000 people with annual incomes up to $17,744 for an individual and $35,670 for a family of four.

Despite opposing Amendment 2, Gov. Mike Parson’s budget fully funds Medicaid expansion as he vowed to do after it was adopted.

The governor sets the cost of Medicaid expansion at $1.9 billion, including $120 million in state general revenues.

The overall budget proposal calls for $14.1 billion for Medicaid, including $2.7 billion in general revenue. Medicaid in Missouri cost $10.8 billion in fiscal 2020, about 4 percent more than the previous year, according to the state’s Department of Health.

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