Missouri Senate has one more chance to fund Medicaid expansion


JEFFERSON CITY, Mo. – Lawmakers have less than two weeks to get a balanced budget to the governor’s desk, but if funding Medicaid expansion is in the plan, it’s still not for sure.

Representatives voted not to fund Medicaid expansion last month, while Gov. Mike Parson requested lawmakers to find a way to pay for it.

Supporters of the expansion now have to depend on the full Senate to get it done before thousands of Missourians become eligible this summer.

The Senate Appropriations Committee met every day this week to get through the dozen budget bills sent over from the House.

One of the most heated discussions during the week-long committee was if the Senate should support Medicaid expansion.

“I think it is absurd to sit up here and second guess people who voted for Medicaid expansion because if that’s the case, they need to second guess the people that they elected,” committee member Sen. Karla May (D-St. Louis) said.

The committee took up the Medicaid discussion after 10 p.m. Wednesday and debated it for nearly an hour.

“The initial petition question purposely did not include a tax increase because they knew it would fall,” Sen. Denny Hoskins (R-Warrensburg) said.

Medicaid expansion has been no easy topic for lawmakers this session. 53% of voters approved the measure on the August ballot.

“There are peoples’ lives who have been lost, whose dreams have gone unfulfilled as a result of not funding this line,” ranking minority member on the committee Sen. Lauren Arthur (D-Kansas City) said.

The appropriations committee chair Sen. Dan Hegeman (R-Cosby) told the committee he agrees with the House to not fund expansion.

“My recommendation is to take the House’s position on Medicaid expansion,” Hegeman said.

The committee’s vice-chair, Sen. Lincoln Hough (R-Springfield), disagrees with Hegeman and proposed to fund Medicaid expansion but at half of what the governor requested.

“The proposal I put before the committee, I would argue a more measured approach in doing that roughly half of what the governor recommended,” Hough said. “I wouldn’t put this proposal forward in front of this committee without the beliefs that this is the right path to go down.”

Expansion is estimated to cost around $1.9 billion, with less than $130 million from the state. Gov. Parson recommended $120 million in his budget to lawmakers.

Some committee members stressed they are concerned about the courts getting involved.

“It worries me, and I don’t want judges to legislate from the bench, I want to be able to have control of what happens, I want to be able to have an understanding of what the long game is,” Sen. Karla Eslinger (R-Wasola) said. “I admittedly oppose Medicaid expansion, but I don’t think that’s the question before us.”

Sen. Tony Luetkemeyer (R-Parkville) is a lawyer that sits on the committee who argued the courts have no say in how money is spent.

“Those of you who are thinking about voting a certain way because of how you fear the Supreme Couty, a non-policy making body, a non-elected body, a body that is not subject to the will of the people, that is not the role that we play,” Luetkemeyer said.

The 14-member bi-partisan committee voted in a tie on if Medicaid expansion should be in the state budget. Three Republicans joined the four democrats in a “yes” vote.

Since the vote ended in a tie, Hegeman said the proposal was defeated.

“Why are we afraid to let the taxpayers’ federal dollars, that they paid every time they get a check, they are paying federal dollars, and their federal dollars should come back home and work for them and not go to some other state,” May said.

Sen. Bill Eigel (R-Weldon Spring) said the entire Medicaid system needs reform, and the state should not give the program any more money until then.

“By allowing a program to persist in a manner that is so wasteful and so poorly run without any single attempt of reform that I have seen in the five years I have been in this chamber is not only incredibly irresponsible but could go down as the turning point disastrous, fiscal decisions made by this general assembly for the history of the state,” Eigel said.

On Thursday Parson said it’s a waiting game to see what the full Senate does.

“I’m not sure what the game plan will be, we are talking through scenarios now. If it doesn’t pass, what can we do and what obligations do we do, what is it going to look like in the courtroom,” Parson said. “I said all along I didn’t support the expansion when it was out there, but I don’t have the opportunity to just represent a district anymore like when I was in the Senate or House, my job is to represent the entire state right now and the majority of people voted for it and that’s why I put it in my budget.”

Senate Majority Floor Leader Caleb Rowden (R-Columbia) said he knew it was ultimately going to be decided in court.

“It was going to go to court either way,” Rowden said. “We put the money in, folks on the right were going to sue and vice versa. I don’t think the court has the power to tell us to move money from point A to point B, but I do think the court has the power to tell us what the constitution already tells us.”

Senate Minority Floor Leder John Rizzo (D-Kansas City) said his caucus is prepared to filibuster and debate on the floor next week to put funding for expansion back into the budget.

“I do intend for the people in my caucus to make their points and their feelings known,” Rizzo said. “They didn’t do what the will of the voters want to do, but more importantly, they threw their own governor under the bus. I mean he put Medicaid expansion in the budget.”

If the Senate adds the funding for expansion back into the budget, Senators will have to go to a conference with the House. Lawmakers must have a budget to Parson by May 7.

The expansion goes into effect July 1 and anyone that makes less than $18,000 a year is eligible. An estimation of 275,000 Missourians will be added to the program.

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