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Parson hopes for swift action on Medicaid expansion

  

JEFFERSON CITY, Mo. — Gov. Mike Parson is hoping for a swift solution for expanding Missouri’s Medicaid program after the Supreme Court said the amendment was constitutional. 

Specifically, the Supreme Court of Missouri unanimously remanded a lower court’s decision and said the constitutional amendment did not appropriate money or hamper the legislature’s discretion in appropriating funds — which would have been unconstitutional. The expansion opens up MO HealthNet to about 275,000 lower-income Missourians. 

The issue of implementation is back in Cole County Circuit Court next week. 

“We’ve got to figure out a solution. I don’t think this is something we can sit on for months and say we’re not going to do anything,” Parson told The Missouri Times in an interview. “It was a unanimous decision on the Supreme Court which pretty well tells you, like it or not, that’s the decision, and we’ve got to figure out how to deal with that.” 

“My biggest concern is we don’t want a judge making all those decisions for the legislative body and for the executive branch,” he continued. “I think it’s important that we take some sort of action, and the legislature will have to be involved in that process.” 

Parson said there would need to be a concrete solution in place if he was to call legislators back to Jefferson City for a special session. But lawmakers in both chambers and on both sides of the aisle are speculating there’s enough money already appropriated for the Medicaid program until at least January when lawmakers will already be back in the Capitol and can pass a supplemental budget. 

“If the department is compelled through judicial action to implement and enroll benefits toward the expansion program, they’re going to have to pay for it out of money appropriated for other populations in the Medicaid program,” House Budget Chairman Cody Smith said Thursday. “That means they will run out of money much sooner than they would normally, and unless they cut Medicaid rates or shoehorn the benefits into the amount appropriated — which means cutting services to someone somewhere — they’re going to have to ask for additional appropriation for additional benefits.”

Smith said in recent years lawmakers have been able to pass supplemental budgets toward the start of the legislative session. 

Senate Minority Leader John Rizzo was averse to the idea of a special session to appropriate additional funding if the department can hold off until a regular session — especially considering the proclivity for special sessions to go off-topic. Rizzo said he’s been given information pointing to funding lasting until January or February. 

“You need to expand. The people want that; the courts have clearly paved the way to do that,” Rizzo said. “You definitely have this bigger pool of people who are eligible.”

Demonstrators gather outside of the Capitol in support of funding Medicaid expansion. (THE MISSOURI TIMES/CAMERON GERBER)

Missourians voted to become the 38th state to expand its Medicaid program in August 2020, moving to cover more than 270,000 people who earn less than $18,000 a year. Despite several attempts, the legislature did not approve a dedicated fund before passing its budget.

During his State of the State address earlier this year and in his budget recommendations to the General Assembly, Parson said he believed in “uphold[ing] the will of the voters.” However, he dropped the plans to expand it after the legislature did not proffer funding. 

Smith said the governor was “now in a difficult place between two branches of government” and vowed to work with him on a solution. 

“I find it absurd that the seven people in Missouri who think that we did appropriate money for Medicaid expansion are the seven members of the Missouri Supreme Court,” Smith said. “From the legislature’s perspective, we’ve spoken on this, and obviously we’ve been through a lengthy debate and process.” 

The expansion had been slated to take effect July 1.