The Missouri Senate has passed a $34 billion state budget proposal without funding an expansion of Medicaid. The upper chamber sided with the Senate Appropriations Committee and the Missouri House of Representatives by rejecting attempts to put expansion funding into the budget that begins in July.

Missouri Senate Majority Leader Caleb Rowden, R-Columbia, presides over the Senate in Jefferson City on March 4, 2020 (file photo courtesy of Senate Communications)

Gov. Mike Parson’s budget request for Fiscal Year 2022 included money to fund an expansion.

Last year, 53% of Missouri voters supported letting another 275,000 low-income adults become eligible for government-funded health care coverage.

The legislative decision is expected to end up in court to figure out whether the General Assembly is obligated fund the expansion.

During Wednesday’s Senate work on the budget, Republicans Justin Brown, Mike Cierpiot, Lincoln Hough, and Caleb Rowden sided with Democrats and supported expansion funding, but that was still not enough to restore the money.

Rowden, R-Columbia, said he has voted against expansion many times, but he said that’s not the question.

“I think the question before us tonight is really simply if we believe that we should fund the expansion that the people of Missouri voted on,” said Rowden. “And for me personally, the answer to that question is I think that we should. Over the weekend I asked myself a couple of questions internally that have kind of informed my opinion a little bit. The first question is whether or not I actually think we are going to stop the funding of Medicaid expansion at the end of this process and for me, the answer is no. I do think what a Missouri court can tell us is that we have to allow Missourians within the expansion population to apply and to receive Medicaid service, which was the main purpose of the 2020 initiative. I believe the court can do that – I believe the court will do that. When they do, folks in the expansion will be allowed to apply, and we will be presented with a very, very large supplemental budget in October, or November, or December of next year.”

Kansas City Democrat Lauren Arthur said Republicans who rejected expansion claim to be pro-life.

“We’ve heard cynical excuses for not expanding Medicaid,” said Arthur. “I listen to my GOP colleagues fight time and time again against helping hundreds of thousands of Missourians gain access to health care and that obstruction killed people. Some GOP colleagues are claiming that they can’t support funding Medicaid expansion, that it’s okay for the Senate not to fund it because their particular districts opposed the measure. That’s not how democracy works. This was a statewide election and we all live with the result.”

Sen. Bob Onder, R-Lake St. Louis, calls expansion “fiscal insanity of a welfare program.”

“The fundamental argument is how big do we want the welfare state to be? It’s easy to just say, ‘Take the federal money and run. Take the federal money and run. It’s free money. Money grows on trees. The federal printing press will print on forever. So why not take the free money,’” said Onder.

A committee of House and Senate members will head to the negotiating table early next week to work out their budget differences.

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