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A look at Parson’s recommended Medicaid expansion budget

JEFFERSON CITY, Mo. — After Missouri voted to approve Medicaid expansion in August, funding has been on the minds of many in state government — including that of Gov. Mike Parson

“Like I have said many times, I will always uphold the will of the voters, and we will move forward with expanding Medicaid coverage to approximately 275,000 Missourians,” Parson said during his State of the State address Wednesday. “However, it is important to remember that the costs of this expansion will be significant – hundreds of millions of dollars, in fact. This will have a major impact on other areas of our budget, and we must plan accordingly, which means staying vigilant in maintaining the program’s integrity by protecting against fraud and waste.”

Parson’s recommended budget, released to the General Assembly Wednesday, earmarked $1.9 billion for Medicaid expansion for the next fiscal year. Of that, $1.65 billion is set to come from federal funds, with the remainder coming from general revenue and various taxes. 

The income benchmark will be set at less than $18,000 for an individual or $30,000 for a family of three. The changes are set to take effect on July 1, the beginning of the 2022 fiscal year

Comprehensive medical benefits will cover 45,000 adults with substance abuse disorders and severe mental illness and another 5,000 adults with other complex health conditions.  

Parson’s recommendations designated nearly $11 billion to the Department of Social Services (DSS) for the entirety of the program for the upcoming fiscal year, while $8.8 billion was appropriated for the program for FY 21. 

While Parson wasn’t an advocate for the expansion prior to its approval last year, those across the aisle praised his commitment to following through on the program this week.

“Medicaid expansion is the law of the land,” Healthcare for Missouri spokesperson Cecilia Belser-Patton said in a statement. “With today’s budget, the governor is acknowledging that fact and sending a strong message that it’s time for all of us to roll up our sleeves and go to work for the Missouri people. Lawmakers in both parties need to fund the Medicaid budget, respect the will of the voters, and fully implement this critical program without delay.”

Though they noted this year’s recommendation was cleaner than expected, Appropriations Chair Sen. Dan Hegeman and State Budget Director Dan Haug shared concerns about the process going forward. 

“We were able to get the Medicaid expansion into the budget this year without having to cut other programs, but I’m very concerned that the ongoing expenses it’s going to put on the state budget are going to crowd out our ability to spend on other important programs in the state such as education going forward,” Haug told The Missouri Times. “While we didn’t have to make cuts in this initial budget, I am very concerned about what it’s going to do to our budget in the future.”

Missouri became the 38th state to expand its Medicaid program last year.