On Thursday, a plan to expand Medicaid eligibility in Missouri was blocked from reaching the House floor after the Republican-controlled House Budget Committee voted down a bill that would have created a $1.6 billion spending plan for the program. Missouri Republicans claim that the state cannot afford the expansion, an assertion that Democrats in the state dismiss as blatantly false, due to the fact that the state will receive $1.1 billion of funding from the federal government specifically for Medicaid expansion from the recently passed American Rescue Plan. (That’s on top of the $2.8 billion of other federal aid that Missouri will be receiving.)
The decision to block the Medicaid funding is in direct opposition to the wishes of Missouri voters, 53% of whom voted to support the expansion in a ballot question last August. The expanded eligibility would allow an additional 230,000-275,000 low-income residents of the state to receive coverage under the state health care program. According to Missouri House Rep. Peter Merideth, the decision to reject the expansion of the program could leave the entire Missouri Medicaid program underfunded when thousands more Missouri residents become eligible. Refusing to go forward with the expansion, which is a part of the state constitution after the results of the ballot measure, could even land Missouri in court.
Currently, Missouri, one of the small number of states that haven’t yet expanded Medicaid, has one of the lowest Medicaid eligibility thresholds in the entire nation. The only groups that are eligible for Medicaid in Missouri at the moment are disabled people, children, and parents with incomes under 18% of the federal poverty level—which comes out to less than $5,800 per year for a family of four. Under the expansion, adults earning up to 138% of the federal poverty level will also be able to receive Medicaid coverage.
Although a number of state Republicans claimed that rural Missouri residents didn’t support the expansion in an attempt to imply that the support for the Medicaid expansion overlooks the desires of rural constituents, the truth is that the measure would not have passed without the one in three rural Missouri voters who voted in support of increasing eligibility.