Missouri voters could get to decide whether to expand Medicaid health care coverage for thousands of low-income adults after a decade of repeated rejections by the state’s Republican-led Legislature.
Supporters of a proposed constitutional amendment said Friday that they turned in nearly 350,000 initiative petition signatures to place the proposal on the November statewide ballot. That’s about twice as many valid signatures as needed, though election officials still must verify the names.
Social distancing requirements and stay-at-home orders caused by the coronavirus outbreak have stymied other initiative petition drives in Missouri and elsewhere. But supporters of Missouri’s Medicaid expansion proposal began gathering signatures last fall and completed most of their work by Missouri’s March 10 presidential primary, before the coronavirus restrictions were put in place.
“The need for Medicaid expansion was apparent before the outbreak and only becomes more critical as the pandemic continues,” said campaign manager A.J. Bockelman. “It’s time to help the workers hit hardest by this crisis and bring billions of our tax dollars home to create jobs once this outbreak is under control.”
Supporters estimate 230,000 additional low-income adults would enroll in Medicaid, if voters approve the expansion.
Thirty-six states have adopted Medicaid expansion measures, including several Republican-leaning states where voters approved ballot measures.
Missouri’s GOP-led Legislatures has repeatedly defeated Democratic attempts to expand Medicaid under the terms of the health care law signed by President Barack Obama in 2010. That law provides a higher-than-usual federal funding share for states that expand Medicaid coverage to adults earning up to 138% of the federal poverty level, about $17,600 for an individual or $30,000 for a family of three.
Missouri’s Medicaid program does not cover most adults without children. The income eligibility threshold for adults with children is about one-fifth of the poverty level, one of the lowest cutoffs nationally. Eligibility thresholds are higher for children, seniors and the disabled.
Supporters of Medicaid expansion have pointed to studies predicting that increased federal Medicaid money flowing to doctors, hospitals and other medical providers could spur creation of thousands of jobs while improving the health of lower-income working adults.
But opponents have said Medicaid expansion will drive up costs for state government, which already is hard pressed because of the coronavirus hit to the economy.
Republican Gov. Mike Parson said Friday that Medicaid rolls are likely to swell even without expanding eligibility, because a sharp rise in unemployment could leave people without privately funded insurance. Parson said the state cannot afford to broaden eligibility to more low-income adults.
“I don’t think it’s the time to be expanding anything in the state of Missouri right now,” Parson said. “There’s absolutely not going to be any extra money whatsoever.”
A ballot estimate prepared by Missouri Auditor Nicole Galloway’s office says the state’s financial implications could range from an additional $200 million of costs annually to $1 billion of annual savings by 2026. Galloway, a Democrat who is running for governor, supports Medicaid expansion.