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Will lawmakers work to undermine Medicaid vote?

Austin Huguelet Springfield News-Leader

After years of rejection at the statehouse, Medicaid expansion won voter approval last week. But that won’t end the debate in Jefferson City.

The plan to offer state-run coverage to hundreds of thousands more low-income adults still has to be budgeted and implemented, and many lawmakers who opposed it will likely be in charge of that process.

That is raising questions about whether those politicians will try to undermine the vote between now and next July, when expansion is set to take full effect.

Two of the GOP’s fiercest expansion critics said week they have no plans to continue the debate.

Gov. Mike Parson, who once called expansion “a massive tax increase that Missourians cannot afford,” said after last Tuesday’s vote that “the people of the state of Missouri voted (expansion) in, so we’re going to have to deal with it and implement it.”

Rep. Steve Helms, R-Springfield, who last year filed a bill aimed at making it harder to pass expansion on the ballot, had a similar take.

“I think we should see how it works,” he said. “The voters voted it in, so let’s see what happens.”

But they also made clear they think it’ll cost the state dearly and raised the specter of painful budget cuts to compensate.

“You're probably looking at $200 million or something like that off the bat,” Parson said, “so we've got to figure out where that funding is going to come from. Hopefully the economy gets better … but right now, it's tough times.”

“And unfortunately,” Helms said, “the people that will suffer from that are the least able to afford cuts to education and other social programs.”

Democrats pounced on those comments, calling it all dishonest nonsense.

State Auditor Nicole Galloway, who is hoping to unseat Parson in November, said studies suggest expansion will actually save the state money by shifting certain costs to the federal government. The most prominent of those studies, a 2019 report from Washington University in St. Louis, projected $932 million in savings by 2024.

And she said Parson really can’t be trusted to implement expansion at all given how he supported forcing another vote this year on a redistricting reform package voters passed in 2018.

“Governor Parson will undermine our vote,” she said. “I don’t think he can be trusted at his word.”

House Minority Leader Crystal Quade of Springfield said the same applies to Republican legislators like Helms who currently hold veto-proof majorities in each chamber.

Asked how, Quade pointed to a resolution House Budget Chair Cody Smith, R-Carthage, sponsored this spring that would have asked voters to make a change Smith himself conceded could "theoretically” allow legislators “to choose not to fund Medicaid.”

"Fortunately that did not pass," Quade said. "But we know that they're going to try again the moment that we go back in January."

It’s not clear how many Republicans are actually planning to do that. Smith’s office did not respond to a request for comment.

But the top budget writer in the Senate suggested it’s too early to speculate on anything before the session gets closer and the state’s financial outlook gets clearer.

“It just passed,” said Sen. Dan Hegeman, R-Cosby. “We’re going to work with the governor’s office and we’ll see what our financial situation is next year when the legislature reconvenes to do the budget.”

Other Republicans were more bold, though.

Sen. Bob Onder, R-Lake St. Louis, told the St. Louis Post-Dispatch that budget writers could use a July court decision to effectively ignore the vote.

“Money is tight whether folks passing the amendment want to admit it or not,” Onder told the newspaper. “I just don’t see it happening next year.”

And Sen. Eric Burlison, R-Battlefield, told the News-Leader that’s not out of the realm of possibility.

“There are going to be a lot of attorneys looking at this to see what flexibility we have,” he said. “And from my understanding, you can’t take away the legislature’s authority to appropriate, so if the budget chairs in the House and Senate decide not to fund that line item, then at the end of the day it doesn’t happen.”