The State Auditor’s Office estimated 250,000 Missourians will be added to the state-funded welfare program. The measure is expected to cost taxpayers up to an additional $400 million dollars a year after federal funding ends. The measure passed 53 percent to 47 with Missouri becoming the 38th state to expand.
“This is a tremendous victory for Missouri’s working families,” Democrat gubernatorial candidate Nicole Galloway said in a statement. “Medicaid expansion brings billions to the state annually, creates jobs in places that desperately need them and saves rural hospitals. We can expand healthcare without raising taxes or cutting other programs.”
Economists and a majority of lawmakers opposed the measure. “Medicaid is for aged, blind and disabled individuals…the biggest problem is that it is putting able-bodied working adults on the system,” Republican representative Sara Walsh said. “It’s going to cause a massive tax increase, which is the only way to be able to get around this with either a massive tax increase or to cut services.”
Medicaid’s current budget is almost $12 billion for fiscal year 2021. The state’s current operating budget is about $35.2 billion.
“More than $1 billion has been cut from the state’s general revenue budget in recent months,” House Budget Committee Chairman Cody Smith stated last month. “Just this month, services requiring state support have been drastically reduced, including elementary school funding, college scholarships and support services for those in need. Amendment Two will be a knockout blow to the state budget as more services will be cut or eliminated to pay for the health care of able-bodied adults.”
With expansion, the state will have to pay to cover more Missourians, but the federal government will also pay the state more to cover Medicaid costs. At least for the first few years.
The federal government will initially cover 90% of the costs for newly eligible patients, and Missouri picks up the remaining 10%. The federal amount then reduces each year until the state picks up a majority of the tab, which will cause the state to raise taxes to pay for it.
Some lawmakers and others believe that 10% will strain the state’s already struggling budget.
“That 10% is going to be real, it’s going to be hard money, it’s going to be money out of the pockets of the taxpayers of Missouri,” Carl Bearden, CEO of United for Missouri, said.
Around 350 organizations supported the Say Yes On 2 campaign, led by Missouri Healthcare for All. The Say No on 2 campaign website shows eight organizations endorsed it.
The next steps for expansion is implementation through the state legislature.
“Democrats are going to support Medicaid expansion,” Democratic representative Kip Kendrick said. “And then the General Assembly either in 2021 or 2022, we’re going to come back in and try to find ways to undermine the will of the people and put further restrictions in or find a ways to narrow Medicaid expansion that would go against what the people voted on.”
Those who oppose expansion are concerned what the yes vote will do.
“What this ballot initiative does, is it ties our hands by the Constitution,” Republican representative Doug Richey said. “This is a constitutional amendment. We don’t have the ability to go in and clean it up if we made a mistake.
Pro-life groups, including Missouri Right to Life, warn that Amendment 2 and Medicaid expansion will open the door to taxpayer-funded abortions and threaten pro-life programs that are assisting young women.
The Missouri Times reports that “Currently, Medicaid dollars are restricted from being used to fund most abortions by the Hyde Amendment, which is an annual rider on a federal appropriations bill. Before Hyde was put in place, an estimated 300,000 abortions nationally were paid for by taxpayers every year.”
Under Medicaid expansion, those restrictions could go away.
–Dwight Widaman | Metro Voice