Wednesday, March 31, 2021

Carthage Republican: Medicaid expansion is wrong for Missouri


By Rudi Keller

The Republican majority in the Missouri House on Tuesday beat back every attempt by Democrats to restore funding for Medicaid expansion to the budget for the coming fiscal year.

The House spent more than seven hours debating the 13 spending bills that comprise Missouri’s $32 billion spending plan for fiscal 2022 state operations. On voice votes, the House gave first-round approval to all 13 bills, plus a supplemental budget bill for the current year.

(House Budget Committee Chairman Cody Smith, R-Carthage, left, watches floor debate on state spending with Speaker Rob Vescovo, R-Arnold. Photo by Tim Bommel/Missouri House)



On Thursday, roll call votes on all 14 bills will send the budget to the Senate for its input.







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

Democrats started early and took every opportunity to put the money back – including an attempt to tap money promised by the $1.9 trillion federal COVID-19 relief bill passed early this month – but could persuade only a handful of Republicans to break ranks with the majority.

“I think Medicaid expansion is wrong for Missouri,” House Budget Committee Chairman Cody Smith, R-Carthage said. “I think it is wrong for the state budget.”

Throughout the debate, Democrats argued the state’s unprecedented surpluses would be increased, not diminished, by approving the program. But Republicans argued that tight state finances won’t allow the new expense.

“It is just stubbornness and cruelty to refuse this money,” said state Rep. Sarah Unsicker, D-Shrewsbury.

The Affordable Care Act, passed in 2010, promised that states would pay no more than 10 percent of the cost of expanding Medicaid 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.

The state pays about 35 percent of the cost of the existing Medicaid program.







After years of fruitlessly trying to persuade the Republican-led legislature to accept the deal, proponents used the initiative petition process to put it on the ballot and it passed in August with 53.3 percent of the vote.

Parson’s budget estimated that 275,000 Missourians would receive coverage, at a cost of $120 million in general revenue and $1.9 billion overall. Since the budget was proposed, Congress passed the American Rescue Plan, which offers states that have not expanded Medicaid an incentive to do so by cutting the state’s share of the existing program by 5 percent.

That change is worth about $1.15 billion to Missouri over the next two years.

For education, the budget granted initial approval in the House includes $3.6 billion for public schools under the foundation formula, increases basic support for colleges and universities to the fiscal 2020 appropriation levels, an increase for all the institutions because a portion of that money was withheld.

The budget also includes a 2 percent pay raise for state employees, plus additional raises for workers in the Department of Corrections to aid in recruiting corrections officers. It also has money for implementing the law to stop automatically charging 17-years olds as adults.

Throughout the day, Democrats complained that billions of dollars are being allowed to accumulate unspent in the state treasury. The state general revenue fund is expected to have a surplus of more than $1 billion on June 30, while other unrestricted funds, some related to federal COVID-19 relief, are amassing balances approaching $500 million.

The $1.9 trillion relief bill approved earlier this month will bring about $2.8 billion to the state for its general needs.

“We are sitting on a billion dollars plus and we have more coming in and it is time we started spending it,” said state Rep. Peter Merideth, D-St. Louis, as he unsuccessfully sought $50 million to eliminate rider fares on mass transit for a year.

Smith, however, said he has no confidence that federal spending can be sustained.

“They are deficit spending at an unprecedented rate,” he said.

Rudi Keller covers the state budget, energy and the legislature. He’s spent 22 of his 30 years in journalism covering Missouri government and politics, most recently as the news editor of the Columbia Daily Tribune. Keller has won awards for spot news and investigative reporting.

2 comments:

Mo Rage said...

Once again, like on the people voting down the "Right to Work" law some time ago, we, the people, vote on something, let our will be known but the GOP, the Republicans do away with it.

We all, Missourians, voted to end the Right to Work legislation and we voted to expand Medicaid but the Republicans upended both our votes. Not done there, our own Kansas City Star reports that one representative, Justin Hill of Lake St. Louis, is quoted as having said “I am proud to stand against the will of the people.” What unmitigated gall.

Clearly he and his fellow Republicans know not at all how our election system and government is supposed to work. And check this out--from the same Star article: "Business people, social workers and others stood on the floor repeating the facts: Missouri has more than enough money to extend health insurance coverage to the working poor. Expanding Medicaid will actually bring more money into the state."

This is insane. This is obscene. This is heartless and immoral. The way these Republicans would have it, it's all only for them and their own political party and their donors. This is wrong. So wrong. We must stand up, Missourians. And we must vote these people, these Republicans, out of office. They must be made to pay for not just ignoring but denying the will of we, the people.

Sherry Buchanan said...

Interesting that Cody Smith's opinion about Medicaid Expansion is more important than 53.3% of MO voters. He assumes that his election by a relatively tiny number of people in his district gives him the power to nullify a statewide majority and to defy a constitutional requirement.