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Medicaid Expansion Supporters Vow To Fight After Missouri Governor Scraps Voter-Approved Plan

Rev. Vernon Howard, president of the Kansas City chapter of the Southern Christian Leadership Conference, urged Missouri Medicaid expansion supporters to continue to fight.
Alex Smith
Rev. Vernon Howard, president of the Kansas City chapter of the Southern Christian Leadership Conference, urged Missouri Medicaid expansion supporters to continue to fight.

Medicaid expansion supporters say Republicans' refusal to implement the constitutional amendment will result in delays of health care for Missourians in need.

A day after Missouri Gov. Mike Parson declined to implement a voter approved constitutional amendment to expand the state’s public health insurance program, myriad supporters of the plan vowed to keep up the fight.

In Kansas City and across the state, health care advocacy groups gathered to express support for expanding Medicaid, which had been slated to begin on July 1 and provide health care coverage to an additional 271,000 Missouri residents.

Dozens protested Friday morning at Trinity United Methodist Church in Kansas City, with speakers urging the crowd to continue pressuring Missouri leaders.

“We will not go away! We will not be silent! We will not back down! And we will continue to fight for what is right!” Rev. Vernon Howard, president of the Kansas City chapter of the Southern Christian Leadership Conference, exhorted the gathering.

Many protesters expressed frustration with Parson, a Republican who, though a vocal expansion opponent, had initially said he would follow the will of voters who had approved the constitutional amendment.

“Our governor, Mike Parson, lied for months,” Jobs With Justice organizer Jameson Wells said.

Parson on Thursday announced he would withdraw the plan to expand Medicaid that the state had submitted to the Centers For Medicare and Medicaid Services after the Republican-controlled legislature refused to fund it in the state budget.

“Without a revenue source or funding authority from the General Assembly, we are unable to proceed with the expansion at this time and must withdraw our State Plan Amendments,” Parson said in a statement.

The Missouri Constitution requires new appropriations to have a source of funding. Parson cited a Missouri Court of Appeals decision last year in a case brought by expansion opponents challenging Medicaid expansion ballot language. But the court allowed the language to remain on the ballot.

Fifty-three percent of voters approved the amendment last August following years of campaigning by hospitals, health care providers and health advocacy groups.

In a statement, U.S. Rep. Emmanuel Cleaver II called the actions by the state legislature and governor an “alarming display of contempt for voters and the rule of law.”

Dave Dillon, a spokesman for the Missouri Hospital Association, a major supporter of expansion, said in an email that voters had “a right to be disappointed in the actions of the Governor and General Assembly.”

Health advocacy groups said the governor's action would cause harmful delays in health care for many Missouri residents.

“Cancer patients cannot wait for legal battles to access the life-saving coverage that Medicaid expansion provides," Emily Kalmer, government relations director for the American Cancer Society Cancer Action Network, said in a statement.

Missouri has some of the most restrictive requirements in the nation for Medicaid eligibility. Known as MO HealthNet, the program is limited to households with income of up to 21% of the federal poverty level, or about $5,000 for a family of three. Expansion would raise the income threshold to 138% of the federal poverty level.

Republican lawmakers have insisted that Medicaid expansion would create financial hardships for the state, forcing them to divert spending from other programs, even though Missouri has a budget surplus estimated at $1.1 billion.

Some Missouri Republicans who refused to authorize funding insisted their constituents had been misled regarding the plan, an accusation that angered some of the participants at Friday’s event.

“The very idea that the people down on the ground living life don’t know what’s going on – come on! That’s just an excuse,” said Rev. Tex Sample, pastor of Trinity United Methodist Church in Kansas City.

Amy Blouin, president of the Missouri Budget Project, a nonprofit public policy organization, called Republicans’ claims about the negative financial impact of expansion “baseless.”

Under the Affordable Care Act, the federal government would pick up 90% of the tab for expansion. In Missouri’s case, that would add up to about $1.6 billion.

Multiple studies and the experience of other states that have expanded Medicaid indicate that expansion would likely save Missouri money because it would allow the state to reduce spending on other health care programs.

A 2019 study by researchers at Washington University in St. Louis estimated that Medicaid expansion in Missouri covering an additional 315,000 adults would save the state $39 million.

In addition, the boost to the economy that would be created through the influx of federal spending would create additional tax revenue and create more jobs, according to research by the Missouri Budget Project.

As a health care reporter, I aim to empower my audience to take steps to improve health care and make informed decisions as consumers and voters. I tell human stories augmented with research and data to explain how our health care system works and sometimes fails us. Email me at alexs@kcur.org.
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