State Sen. Holly Rehder said Friday she is not in favor of funding Medicaid expansion.

"I was elected to represent the people of Southeast Missouri (who) rejected expansion soundly," the first-term Republican senator said, adding, "under the current circumstances, I will be standing with them and voting 'no' if given the opportunity."

On Wednesday, the Senate Appropriations Committee voted 7-7 on a proposal setting aside money for the program. Because it was a tie, the proposal failed.

On April 15, the Missouri House passed an alternative plan, voting 143-1 to shift the money meant for Medicaid expansion into funding for care for the elderly and people with disabilities.

The chair of the House Budget Committee, Cody Smith, said the plan represented "the prioritization of the people who are most needy in our state."

On Aug. 4, Missouri voters approved Amendment 2 (Medicaid expansion) by a 53%-47% margin. In Cape Girardeau and Scott counties, the issue was rejected by virtually identical 68%-32% margins.

Amendment 2 authorized amending the Missouri Constitution to adopt Medicaid expansion for persons aged 19 to 64 with an income level at or below 133% of the federal poverty level, as set forth in the Affordable Care Act.

When fully implemented, Medicaid is expected to expand to cover newly eligible single Missourians with an income of $18,000 a year or less or a family of three with an income of about $30,000 or less. The federal government is expected to pick up 90% of the total cost for the new Medicare enrollees.

According to healthinsurance.org, 887,433 Missourians were covered by Medicaid in April 2020. Amendment 2 authorized adding an estimated 275,000 persons to the program by July 1.

According to the Associated Press, some lawmakers are warning if the Missouri Legislature declines to fund the voter-approved measure, a judge could force the General Assembly to pay for it.

While estimates vary, one report suggests Medicaid expansion will cost Missouri $200 million in general revenue.

Gov. Mike Parson, an opponent of expansion prior to last summer's vote, has said he plans to follow the will of the voters despite concerns about the price tag.