Committee votes down Medicaid expansion funding in Missouri

COLUMBIA, Mo. -- Missouri lawmakers Thursday voted against funding a voter-approved Medicaid health care expansion that's now enshrined in the state Constitution.

House Budget Committee members voted 20-9 against a spending plan to cover thousands of low-income adults under the government health insurance program.

St. Louis Democratic Rep. Peter Merideth called the move "blatantly unconstitutional" in a statement and said if lawmakers don't fund the program willingly, a court will force them to do so.

"Ultimately, Medicaid expansion will happen, despite Republicans' political games in refusing to fund it," Merideth said.

Voters last year added Missouri to the list of states to approve Medicaid expansion under former President Barack Obama's federal health care law.

The state's Medicaid program currently does not cover most adults without children, and its income eligibility threshold for parents is one of the lowest in the nation at about one-fifth of the poverty level.

Expanded eligibility takes effect in July. But the Budget Committee's move Thursday could complicate that, although there's still time for lawmakers to approve funding for Medicaid expansion before the Legislature's May deadline to pass spending bills.

House Budget Committee Chairman Cody Smith said the policy will be debated again when budget proposals go before the full House, which could come as early as next week.

Republicans have cited concerns with paying for the expensive health care program. Although almost all of it will be covered by federal funds, some state revenue is required.

The bill included nearly $1.6 billion for the expansion, with about $119 million coming from state funds and most of the remaining provided by the federal government.

Meanwhile, Gov. Mike Parson recommended a $34 billion total budget for the State of Missouri for the upcoming fiscal year. That includes about $13 billion in federal funding and around $11 billion in state funding.

Some Republicans on the House Budget Committee mentioned competing spending priorities, such as funding to care for people with mental and physical disabilities, in their decision to vote against paying to extend Medicaid. Others raised concerns about committing to expanding Medicaid without knowing whether the state will have enough revenue to fund its share of the program in the future.

Smith also repeated a longstanding GOP concern the state's Medicaid program currently has issues that need to be fixed before it's expanded.

"If we expand Medicaid without doing that, we are simply pouring gasoline onto the fire of problems that could come along due to increased spending," Smith said.