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Missouri pulls Medicaid expansion

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The Missouri Department of Social Services today submitted a letter to the Centers for Medicare and Medicaid Services withdrawing its Medicaid expansion plan.

Gov. Mike Parson's office issued a news release indicating the executive branch lacks authority to expand MO HealthNet, the state's Medicaid program, since the ballot initiative was not self-funding and the legislature voted to not appropriate funds.

“Although I was never in support of MO HealthNet expansion, I always said that I would uphold the ballot amendment if it passed. The majority of Missouri voters supported it, and we included funds for the expansion in our budget proposal,” Parson said in the release. “However, without a revenue source or funding authority from the General Assembly, we are unable to proceed with the expansion at this time."

Amendment 2, the Medicaid expansion ballot initiative, was passed by voters in August 2020 by a roughly 53% margin. Opponents of the legislation have said the state cannot afford Medicaid expansion. In his January 2020 State of the State address, Parson warned expansion could come at the cost of education, workforce development and infrastructure funding, according to past reporting.

The Missouri Senate late last month voted against funding the expansion by a 14-20. According to the St. Louis Post-Dispatch, the decision impacts as many as 275,000 low-income Missourians and likely sets up a court battle.

The nonprofit public policy Missouri Budget Project has estimated the American Rescue Plan Act approved by Congress this year could lower the state's Medicaid contribution by more than $1 billion over a two-year period, according to statehouse reporter Phill Brooks of Missouri Digital News. The estimated state cost for Medicaid expansion is $130 million per year, he said.

Missouri House Minority Leader Crystal Quade, D-Springfield, said the Medicaid decision amounts to Parson "breaking his promise to the people of this state."

"Whatever reputation he once had for respecting the law is gone forever, and he is just another politician whose word can’t be trusted," she said in a statement. "Medicaid expansion will still happen as the constitution requires, but because of the governor’s dishonorable action, it will take a court order to do it."

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