Galloway says she's best suited to expand Medicaid in Missouri

COLUMBIA, Mo. -- Democrat Nicole Galloway said she's the best candidate for Missouri governor to enact Medicaid expansion after voters narrowly approved the measure.

Voters on Tuesday made Missouri the 38th state to expand eligibility for the government health care program to thousands more low-income adults.

The primary election also set the stage for a November showdown between Galloway, the state auditor, and Republican Gov. Mike Parson.

Parson opposes Medicaid expansion and has warned expanding the program will be too expensive and could mean cuts to other government services.

"We can expand health care without raising taxes or cutting other programs," Galloway said in a speech after winning the Democratic nomination. "As governor, that's exactly what I'll do. Gov. Parson won't, so it matters who is sitting in the governor's office next year when it comes time to implement Medicaid expansion."

Gov. Mike Parson speaks during an event at the White House on July 7 in Washington.Alex Brandon ~ Associated Press, file

Attaching her name to Medicaid expansion could help her gain support from voters who cast ballots in favor of the proposal Tuesday, although the constitutional amendment only narrowly won with 53% of the vote.

Parson on Wednesday repeated he'll enact expansion despite his opposition to it, although he again expressed concern about how to pay for it.

"The people voted for it, so we're going to implement it in the State of Missouri because that was the will of the voters," he said. "The big thing is, where do you find the funding for it?"

The financial impact is uncertain, but it could cost the state at least $200 million or save as much as $1 billion annually by 2026, according to estimates from Galloway's office. The auditor's office is required to provide financial estimates for ballot measures.

Missouri'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.

The ballot proposal will expand eligibility under the terms of the 2010 federal health care law signed by President Barack Obama. That law provides a higher-than-usual federal funding share for states that expand Medicaid coverage to adults earning up to 138% of the federal poverty level, about $17,600 for an individual or $30,000 for a family of three.

Galloway noted Parson has said voters have made the wrong choice before. Parson said he wants a repeal of Clean Missouri, a constitutional amendment that changed redistricting and enacted more ethics rules on lawmakers and other elected officials.

A Republican-backed proposal that would undo key sections of the amendment's redistricting changes will be on November's ballot.

"Fundamentally, you think when the people vote you shouldn't be changing that vote," Parson told The Associated Press in 2018. "But the reality of it is that is somewhat what your job is sometimes, if you know something's unconstitutional, if you know some of it's not right."

Parson moved the vote on the Medicaid proposal up from the Nov. 3 general election to Tuesday's primary. Parson said the earlier vote would give the state more time to financially prepare for Medicaid expansion, if it passes. He said his decision was not about politics.

Galloway's campaign has said Parson switched the day of the vote on Medicaid because fewer people typically vote in August compared to November, possibly giving opponents a better chance of defeating the measure.