CAPITOL REPORT

Voters Approve Medicaid Expansion But State Leaders Voice Concern about Its Impact on the State Budget

Tom Hurst State Representative 62nd District
Posted 8/12/20

Missouri became the 38th state to approve Medicaid expansion as more than 53 percent of voters supported Constitutional Amendment No. 2 during the August primary. While the amendment passed, budget …

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CAPITOL REPORT

Voters Approve Medicaid Expansion But State Leaders Voice Concern about Its Impact on the State Budget

Posted

Missouri became the 38th state to approve Medicaid expansion as more than 53 percent of voters supported Constitutional Amendment No. 2 during the August primary. While the amendment passed, budget makers in the state continue to have strong concerns about how Missouri will afford the cost of expansion.
Many of the state’s leaders have been vocal in their opposition to expansion. Gov. Mike Parson has referred to expansion as a “massive tax increase that Missourians cannot afford.” State Treasurer Scott Fitzpatrick said expansion would add another 300,000 people to “a system that’s already strained and is already consuming a massive portion of the state budget, as well as massive portions of the state’s general revenue spending.”
House Budget Chairman Cody Smith noted the state already spends more than $10 billion each year on Medicaid, accounting for nearly 40 percent of last year’s state budget. Even without expansion, the program grows in cost by hundreds of millions annually. Now, the growth in Medicaid spending will far exceed the rate of growth state revenues can realistically be expected to achieve. He said the passage of Amendment 2 will add additional hundreds of millions in state spending. Smith added, “What’s worse is that there is no funding mechanism or source included to pay for it. Because we must have a balanced budget, that’s hundreds of millions that will have to be cut from somewhere, and that usually means education. Proponents of Amendment 2 hold up the benefits of offering health care to able-bodied, working-age adults but are silent on the staggering cost and lack of a plan to pay for it.”
Passage of Amendment 2 means that adults earning up to 138 percent of the federal poverty level will be eligible for Medicaid beginning in July of 2021. With this, Medicaid will expand to individuals earning up to $17,600 a year and up to $36,150 each year for a family of four. Ninety percent of the cost of expansion will be covered by the federal government, but Missouri taxpayers will cover the rest. The Missouri Department of Social Services estimates the cost to the state will be more than $200 million per year, and other estimates have put the added cost as high as $349 million per year.
Budget Chairman Smith said there is no magical pot of federal money that will cover the added cost of Medicaid expansion. He said “it will come from you, and from your kids’ schools, and from your parents’ nursing homes. And it will come from your pocket when Amendment 2 advocates want a tax increase to pay for it.”
Missouri Prepares for
School Reopening
As the traditional start date for school rapidly approaches, the state is gearing up its efforts to help educators navigate the challenges of COVID-19. Gov. Mike Parson recently met with teachers and administrators from across the state to discuss plans for reopening.
Parson said, “We are very grateful for the hard work of our superintendents, administrators, teachers, and all school staff members to prepare for the upcoming school year. It was encouraging to hear about their plans to resume teaching, whether that be onsite classes, virtual learning, or a hybrid of both. There is no one-size-fits-all approach. Every school district will look different based on the needs of its students and community.”
The Department of Elementary and Secondary Education (DESE) has worked closely with the Department of Health and Senior Services (DHSS) to address key questions regarding school reopening. The departments released a document providing information on the strategies that Missouri schools should be prepared to address upon reopening. It addresses issues such as what to do if a student or staff member becomes symptomatic at school, how to handle positive cases of COVID-19 in the school community, and how to best prepare to assist local health officials with contact identification and tracing. The document can be viewed at this link: https://dese.mo.gov/sites/default/files/COVID-MO-K12-Reopening-Guidance.pdf.
The state is also working to provide school districts with adequate personal protective equipment (PPE). The State Emergency Management Agency (SEMA) has made 1.8 million cloth masks available to school districts. DESE and SEMA are working to develop a plan to distribute the masks. DESE and DHSS have also released a document providing guidance on PPE use for school nurses. The document is available online here: https://health.mo.gov/living/healthcondiseases/communicable/novel-coronavirus/pdf/ppe-school-guidance.pdf.
To provide additional assistance to schools, the state is allocating $7.5 million of the Coronavirus Relief Fund to a cost-share program with local counties to help schools cover the costs of PPE. The funds will also help schools cover the cost of cleaning and medical supplies for school buildings and buses. Schools will also be able to utilize Elementary and Secondary School Education Relief Funds provided under the CARES Act for any COVID-19 related expenses, including PPE costs.
“As we move forward with this school year, we remain focused on the health and safety of our students, school staff, and communities as a whole,” said Parson.
New Study Stresses
Importance of Military
Spending in Missouri
A study released this week confirms the immense impact the military has on Missouri’s economy. Commissioned by the Missouri Military Preparedness and Enhancement Commission (MMPEC) and its Office of the Military Advocate, the study shows the military spends approximately $18.2 billion in Missouri, which accounts for more than $29 billion in economic activity.
According to the study, military spending contributes $11 billion to Missouri workers, and supports more than 180,000 jobs, which equates to approximately 7 percent of the state’s workforce. The $29 billion in economic activity equals about 9 percent of Missouri’s Gross State Product (GSP), which is the monetary value of all the goods and services produced in the state.
House Speaker Elijah Haahr said, “Missouri has a large military presence, and for that we can be thankful. These men and women, no matter their rank or role, defend our freedom, and their presence, along with their families’, benefits our communities greatly. This report further proves that the work that the military is doing for us is of the upmost importance.”
MMPEC commissioned the study as a way to gauge the success of state and local efforts to support Missouri’s military installations, defense agencies, and defense contractors. MMPEC and the Department of Economic Development’s Office of the Military Advocate work proactively to support military installations, assist defense contractors, and help members of the military find work in Missouri upon leaving the service.
The study is available online at the following link: https://military.ded.mo.gov/economic-impact-reports.
Visiting the Capitol
As always, if we can ever be of any assistance to you at your State Capitol, please do not hesitate to contact us at 573-751-1344 or toll free at 855-440-4985. You may also reach my Legislative Assistant, Diane, at diane.lindsay@house.mo.gov.
May God bless you!
Tom Hurst
State Representative
62nd District