Missouri likely ‘going to court either way’ as Senate panel rejects Medicaid expansion funds

Jeanne Kuang
·3 min read

A powerful Missouri Senate committee dealt an early blow Wednesday night to Democrats and Medicaid expansion advocates who hoped the upper legislative chamber would restore funding that the House had stripped out of the state budget.

In a 7-7 tie, a proposal introduced by Springfield Republican Sen. Lincoln Hough to partially fund the voter-approved expansion failed to clear the Senate Appropriations Committee.

Two other Republicans, including Lee’s Summit Sen. Mike Cierpiot, joined the committee’s four Democrats in voting for it. Appropriations Chair Dan Hegeman, a Cosby Republican, opposed funding the expansion.

Lengthy debate on the issue is expected when the full Senate votes on the budget next week. But the committee vote indicates it is unlikely the General Assembly will send Gov. Mike Parson a budget that includes the funding he recommended for expansion. That almost guarantees that expansion supporters will take the state to court.

“It was going to go to court either way,” Senate Majority Leader Caleb Rowden, a Columbia Republican, said at a weekly press conference Thursday. “If we put the money in, folks on the right were going to sue, and vice versa, so we knew it was ultimately going to be decided in court.”

Eligibility for the state health care program will open up to roughly 275,000 of the lowest-earning Missourians under a state constitutional amendment that passed statewide with 53% of the vote last August.

Parson opposed the amendment but said he would honor the will of the voters and pay for it. But a majority of Republican lawmakers argue that while passage of the amendment increased eligibility for Medicaid, it does not obligate them to fund the expansion.

Not funding expansion will force Parson’s administration to decide whether to allow the newly eligible to enroll in Medicaid on July 1. On Thursday, he said he has not made that decision but that the administration is “talking through scenarios if it doesn’t pass,” including the likely legal battle.

Parson had recommended using close to $130 million in state funds to pay for the newly eligible. Under the Affordable Care Act, the state would also receive $1.4 billion from the federal government to pay for the bulk of the program, and an additional billion over the next two years through the latest federal aid bill.

The House removed that funding from the state budget last month before sending it to the Senate. It also passed a bill to spend the $130 million elsewhere, including on nursing home reimbursements, more public defenders and school transportation. Rowden said the Senate will likely include some of those proposals in their version of the budget.

The plan Hough proposed in the Senate committee would have spent only $60 million, from other federal aid the state has received during the coronavirus pandemic.

Republicans who rejected the proposal echoed arguments of House members that their districts voted against the expansion. Others said the decision to expand rests with the lawmakers.

“That is our role, it is not the role of the judiciary,” said Parkville Sen. Tony Luetkemeyer, when colleagues said they worried not paying for expansion would invite a lawsuit and allow a judge to dictate the program’s expansion.

On Thursday, Senate Minority Leader John Rizzo, an Independence Democrat, said he was not optimistic the full Senate would support funding for the expansion. He accused Republicans of using the debate to generate “talking points” ahead of next year’s primary elections.

“If they lose [in court] they’ll complain about a liberal judge or something like that, and if they win they’ll claim a victory over Barack Obama, who is no longer in office,” he said.