Missouri GOP tells voters to eat a bag of Richards; blocks funds for Medicaid expansion

August 5, 2020:

We did it!

Missouri just voted #YesOn2 to expand Medicaid, and now, because of YOUR vote, over 230,000 hardworking people will have access to life-saving healthcare! pic.twitter.com/azHN0GJjEW

— YesOn2: Healthcare for Missouri (@YesOn2MO) August 5, 2020

Last summer, when activists in both Missouri and Oklahoma were preparing for this historic vote, I wrote the following:

In Oklahoma's case, they even made sure to learn the lesson of the ID/NE/UT experiences: They made their wording bulletproof by embedding it into the state constitution, which means the governor and state legislators can't screw around with it. OK's Medicaid expansion program will be open to all eligible residents earning up to 138% FPL, period, without work requirements or other red tape.

...Like Oklahoma, Missouri activists are being very smart here, learning the lessons from 2018 and actually amending the MO Constitution. Check out the ballot initiaitive language:

Do you want to amend the Missouri Constitution to:

adopt Medicaid Expansion for persons 19 to 64 years old with an income level at or below 133% of the federal poverty level, as set forth in the Affordable Care Act;

prohibit placing greater or additional burdens on eligibility or enrollment standards, methodologies or practices on persons covered under Medicaid Expansion than on any other population eligible for Medicaid; and

require state agencies to take all actions necessary to maximize federal financial participation in funding medical assistance under Medicaid Expansion?

State government entities are estimated to have one-time costs of approximately $6.4 million and an unknown annual net fiscal impact by 2026 ranging from increased costs of at least $200 million to savings of $1 billion. Local governments expect costs to decrease by an unknown amount.

However, there was one bit in the wording of the proposal near the end which probably should've set off a red flag or two:

Federal law requires states to fund a portion of the program in order to receive federal funding (state match). This amendment does not provide new state funding or specify existing funding sources for the required state match.

Ut-oh.

Well, sure enough, cut to this week:

Republican lawmakers blocked Medicaid expansion funding from reaching the Missouri House floor on Wednesday, posing a setback for the voter-approved plan to increase eligibility for the state health care program.

The House Budget Committee voted along party lines not to pass a bill allowing Missouri to spend $130 million of state funds and $1.6 billion in federal money to pay for the program’s expansion. Under the Affordable Care Act, the federal government picks up 90% of the tab on expanding Medicaid.

The expanded eligibility would allow estimated 230,000 additional low-income Missourians to be covered. It is set to go into effect in July after voters approved a ballot question last August with a 53% majority.

Let me repeat that: The voters clearly and unequivocally stated that they wanted Medicaid fully expanded to 133% FPL (actually 138% in practice), with no strings attached for the enrollees, to start July 1st, 2021, and for the state to pay for its 10% share of the cost, with no screwing around.

...Republicans, citing the cost, have long resisted expanding Medicaid in Missouri, one of about a dozen states that haven’t extended eligibility for the health plan.

...Expansion opponents said the state can’t afford to take on the cost. Deaton said the budget bills present “binary choices” between Medicaid expansion and social services for blind and disabled Missourians.

This is a crock of garbage. Aside from the mountain of evidence that ACA Medicaid expansion helps states by bringing hundreds of millions, or even billions of dollars into the state economy) far more than it hurts them, Missouri residents are ALREADY paying for Medicaid expansion and have been for the past 7 years via the ACA taxes which their higher-income residents are paying to fund the law.

The "we can't afford it" excuse is even more outrageous considering that the American Rescue Plan includes what amounts to a flat-out bribe of $1.15 BILLION to the state of Missouri just for implementing the legally & constitutionally-binding ballot initiative which WAS ALREADY PASSED BY THE VOTERS LAST SUMMER.

The $130 million for the first year would presumably increase over time due to inflation and increased enrollment, but even at $200 million per year, this means it wouldn't cost the state of Missouri one dime for the first five years or so.

The very next quote in the article gives away the real game, however:

“It is to give free health care, government health care to able-bodied adults who can do for themselves,” Deaton said.

And there you have it: It doesn't have a damned thing to do with "budgetary concerns" or "fiscal conservativsm"...it's all about the roundly-debunked claim that "lazy poor people" love to sit around all day and soak up that sweet, sweet free healthcare coverage.

Moberly Rep. Ed Lewis said despite that 53% of those who voted cast ballots in favor of expansion, the number did not amount to a majority of Missouri’s eligible voters or population.

“Rural Missouri said no,” said Rep. Sara Walsh, of Ashland. “I don’t believe it is the will of the people to bankrupt our state.”

Holy crap. The Missouri Republican Party is now flat-out denying the democratic process itself.

As an aside, I should note that GOP Rep. Ed Lewis won his last election with 13,064 votes. That may have been 76.9% of those who voted, but only 65.7% of Missouri's eligible voters showed up to vote last November, which means only just barely 50% of them voted for him...and with 34,326 residents, only 38% of his district's population voted for him.