LTE: Representative Bill Owen

As Missouri approaches the upcoming General Election, I remain surprised at the lack of attention on Amendment 6 by all the interest groups concerned with state funding, from public education to mental health assistance to social services. If you recall, one feature of A6 would retroactively lock in place any amendments that have passed since 2010 and also raise the threshold to an unparalled 80% to repeal them (Section 56.3). Expanding Medicaid to able-bodied adults would be one such vote. I recall numerous legislators standing against expansion and later traveling the state sharing that the approval of Medicaid expansion to able-bodied adults would dramatically impact virtually every aspect of state government “down the road”. Medicaid expansion was approved by voters in 2020 with no revenue stream to pay for the billions of dollars of increased spending. “Down the road” is already here.

Missouri voters need to consider the Medicaid program’s current funding cost increases, which over the last 10-plus years have never leveled off or decreased. Couple this fact with the intent of the Federal Government to place a greater share of Medicaid costs on each state, that we are now at the point where state budget writers are transferring significant resources away from education and other vital programs important to Missourians. In short, the vote to expand Medicaid with no revenue stream is directly offsetting funding that goes to education, public safety, and infrastructure projects.

Fiscal Year 2026 ended on June 30th and we already know Missouri spent more than $19 billion dollars for all Medicaid expenses this past year. The program cost $17.4 billion in FY2025 and going back only to FY2021 it cost taxpayers just $11.5 billion. 

Consider this: the Medicaid program will be double in cost between FY2021 and FY2028.

Couple this reality with spending commitments for Medicaid changing at the federal level and Missouri will not have the resources to make up the difference and at the same time maintain other state programs. 

If Amendment 6 passes next month, it will be nearly impossible to acquire 80% of the vote to roll back statutory changes that have unintended consequences. Please think practically about the implications of Amendment 6, and its impact on your neighbors before you vote on this matter. I encourage a No vote on Amendment 6.