Missouri House refuses to pay for voter-approved Medicaid expansion

COLUMBIA, Mo. -- The Missouri House on Thursday passed a budget proposal without funding to pay for Medicaid expansion in an attempt to thwart the program.

Republican House Budget Committee Chairman Cody Smith told a colleague, who is a Democrat, on the chamber floor the goal is to prevent thousands of low-income adults who will become eligible for government health care in July from getting the coverage.

"By intentionally not appropriating for Medicaid expansion, we should not be offering those services to those folks come July 1," Smith said.

Missouri voters last year gave approval to expand the program and enshrined the change in the state Constitution, which prevents the Republican Legislature from undoing the policy without going back to voters.

But Republican lawmakers have long resisted expanding Medicaid, citing concerns ranging from the cost of paying for health care for more people to opposition to providing coverage to able-bodied adults.

Smith on Thursday said it's up to lawmakers to decide whether to pay for the expansion, despite the constitutional change, and their approval to use the funding is necessary for it to be implemented.

Lawmakers -- Democrats -- railed against the decision Thursday, calling it an affront to the voters who called for Medicaid expansion months ago.

"I respect the will of the voters, and I can't support any bill that doesn't fund Medicaid expansion," St. Louis Rep. LaDonna Appelbaum, a Democrat, said.

Although most of the Medicaid expansion would be covered by federal funds, some state revenue is required.

A bill that would have paid for Medicaid expansion included nearly $1.6 billion, with about $119 million coming from state funds and most of the rest provided by the federal government. The bill was voted down in the House Budget Committee.

There's still time for the Legislature to come up with the funding for Medicaid expansion before lawmakers' May deadline to send a budget plan to Gov. Mike Parson, and the proposal hasn't gone before the Senate.

If the money isn't included in the final budget, the state likely would face a court challenge from Medicaid expansion proponents seeking to force lawmakers to fund it.