Missouri Senate votes to not fund Medicaid expansion, joining House

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JEFFERSON CITY. MO. — After hours of debate Wednesday night inside the Missouri Senate chamber, Senators voted to not fund Medicaid expansion. 

The vote was 20-14 against funding. Voters approved the measure on the August ballot, but the House previously voted to not fund expansion, despite Governor Mike Parson recommending it.

Starting July 1, an additional 275,000 Missourians will become eligible for Medicaid. If lawmakers send the governor a budget without paying for the program, it could create a court battle.

During Wednesday night’s vote, four Republican senators sided with the 10 Democrats in voting to expand the program. One of those Republicans was Senate Majority Floor Leader Caleb Rowden, of Columbia. 

“I don’t believe that the question before us is whether or not we supported Medicaid expansion in the past, I think the question before us tonight is simply if we believe that we should fund the expansion that people of Missouri voted on,” Rowden said on the floor. 

Rowden’s district voted to expand Medicaid, but he said he didn’t support it. 

“The real question before is whether or not we’re willing to do something never done before in the state’s history, and that is to not fund our Medicaid obligation,” Rowden said. 

The other three senators who joined Rowden and the Democrats was Sen. Mike Cierpiot, R-Lee’s Summit, Sen. Justin Brown, R-Rolla, and Sen. Lincoln Hough, R-Springfield.

Expansion is estimated to cost $1.9 billion dollars, with less than $130 million coming from the state. 
Senate Minority Floor Leader John Rizzo, D-Kansas City, tried adding expansion back into the budget twice on the Senate floor, but it failed both times.

“You will see hospitals come back to rural Missouri, you will see more doctors and nurses, you will see more health care jobs in this state,” Rizzo said. “Voters of the state of Missouri this last cycle said that they wanted to expand Medicaid.”

Vice Chair of the Senate budget committee Sen. Hough, tried to add expansion back into the budget last week, by recommending half of the governor’s request. That vote was tied 7-7 which means it was defeated. Hough was back on the Senate floor Wednesday night pushing to fund it. 

“So, the idea that we don’t have the money to do this, I don’t buy,” Hough said. “We don’t write a budget for individual districts, we write a budget for the whole state, we write a budget for six plus million people in the state of Missouri.”

The chair of the Senate Appropriations committee Dan Hegeman, R-Cosby, opposed funding expansion for the vote in committee and on the floor. He said he’s worried about depending on the federal government.

“My fear about passing is not what it will do to the state budget this year, but what implementation will do to the state’s budget in years to come,” Hegeman said. “Even before the expansion, Medicaid has continued to grow at a rate that has put a great strain on our state budget.”

Hegeman, along with other Republicans in the Senate, argued that voters weren’t given all the information on how expansion would be funded. He alleged some of the voters’ decision was made in ignorance.

“If the voters had all the information we do, I think they would have made a different decision,” Hegeman said. 

St. Louis Democratic Sen. Karla May called on Republicans for being pro-life but not caring about health care for the child once it’s born. 

“The audacity to take their tax dollars and sit up here and make decisions on where the heck their money should be spent and then not listen to them when they passed the initiative petition, I can’t believe it,” May said. “It’s just so hypocritical to me.”

When asked Tuesday about depending on the Senate for adding expansion back into the budget, Parson said it was too early to make a prediction. 

“I was very open that I opposed expansion before it happened, but I’m the governor of the state of Missouri, and the people of the state voted for it,” Parson said “I don’t have a district anymore. I have to represent all Missourians, and they voted for it, so we put it in the budget, but again, there’s a process to be made to see how it ends up, and then we will move forward.”

Missourians between the ages of 19 to 64 making less than $18,000 a year will be eligible July 1. 

Besides expansion, after nine hours of debate Wednesday afternoon into late Wednesday night, the Senate passed 12 budget bills to make up the state’s $35 billion budget for next fiscal year. 

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