Missouri House redirects money meant for Medicaid expansion

COLUMBIA, Mo. -- The GOP-led Missouri House on Thursday passed an alternative plan for spending funding initially meant for Medicaid expansion.

House lawmakers voted 143-1 to send the proposal to the Senate, where Republican leaders have also voiced support for defunding Medicaid expansion.

House Budget Committee Chairman Cody Smith said the spending plan represents "the prioritization of the people who are most needy in our state."

Instead of using the money to pay for an estimated 275,000 more low-income adults to access the government health care program, the House proposed spending most of the money on care for the elderly and people with disabilities.

Roughly $88 million would go to nursing homes and $25 million would be set aside for services for people with developmental disabilities. The proposal includes enough money to hire another 15 public defenders, and another $15.5 million in the bill would help pay for K-12 school busing,

Missouri voters last year amended the state Constitution to expand Medicaid eligibility, circumventing Republican lawmakers who have long resisted growing the program under former President Barack Obama's federal health care law.

Smith has said his goal in not setting aside funding for the program expansion is to prevent those newly eligible adults from getting health care.

Democrats denounced the move and argued lawmakers are now obligated to pay for the health care expansion because of the constitutional amendment.

St. Louis Rep. Peter Merideth said he and fellow Democrats support the services provided in Smith's latest budget bill. But he said the Republican argument lawmakers must choose between expanding Medicaid and helping the elderly, disabled and other vulnerable groups "is simply false."

"Not only can we do both, but expanding Medicaid actually helps provide more money for us to do these very things," he said.

The federal government pays for most of the cost to expand Medicaid, but Missouri still would need to chip in some state dollars.

Budgeters estimated the expansion would cost $1.9 billion, with the state chipping in about $120 million and the federal government paying for the rest.

There's still time to add the state portion of the tab back into next year's budget before lawmakers' May deadline to send Republican Gov. Mike Parson the spending plan.

But Republican Senate President Pro Tem Dave Schatz, the top state senator, has said he's OK stripping that funding from the Medicaid program.

Republican Gov. Mike Parson included state funding for the expansion in his January budget request to lawmakers.