KANSAS CITY, Mo. — The majority of KC Care Health Clinic's patients are uninsured or have Medicaid. Many of them would be newly eligible for Medcaid under the expansion amendment Missouri voters approved in 2020.
"The expansion would impact a lot of single adults who are working, so if you think about the healthcare costs that those individuals wouldn't be paying if they had Medicaid, you think about all the options and possibilities that presents," said Wil Franklin, president of KC Care Health Clinic. "If you look at the states around Missouri that have expanded Medicaid, access has gone up tremendously. It creates an opportunity for people to be more prevention focused."
By law, clinics like KC Care are required to start enrolling people in Medicaid on July 1. Medicaid expansion will open up healthcare access to 275,000 people in Missouri, including single adults who didn't qualify before.
But lawmakers still haven't enacted the rollout.
The Senate Appropriations Committee on Wednesday voted down a proposal to make room for it in Missouri's budget. The proposal got bipartisan support and would've allocated $60 million of the state's general revenue toward the expansion program.
"It's a delay in their access to healthcare, it's a delay in our access to federal dollars that are going to provide $2 billion to our state in one year alone, that goes to new jobs. We're talking 80,000 to 100,000 new jobs in the healthcare industry," said Rep. Peter Merideth (D), who represents the 80th district in St. Louis. "We're talking about stabilization to rural hospitals that are struggling right now. All of this gets delayed if we force this to be a fight in court."
Missouri democrats, according to Merideth, say it isn't a financial blow to the state.
The federal government gives a 90% match incentive to expand Medicaid.
Senator Denny Hoskins (R - District 21), who voted no to the proposal, said it's not fiscally responsible "to put able-bodied adults on medicaid expansion."
"These dollars we are getting from Biden Bucks will not be available forever and so when you expand Medicaid, that will increase over time," Hoskins said.
Hoskins argues he's within his constitutional right to vote no because the expansion amendment doesn't have a funding mechanism.
However, the federal government would give the state $1.4 billion to pay for Medicaid expansion.
The state also gets another billion dollars from a federal aid relief bill to use in any way.
"This is something I campaigned on, that I was against expanding Medicaid, so I feel like I'm just living up to my campaign promise as well as what voters in my district overwhelmingly decided," Hoskins said.
If lawmakers don't act by July 1, lawsuits are almost guaranteed. GOP lawmakers say lawsuits will happen either way.
"How much kicking and screaming we do and how many people have to suffer along the way depends on what the Senate and House do and what the governor decides to do in response to that," Merideth said.
Gov. Mike Parson, who doesn't support Medicaid expansion but said he'd honor Missouri voters, could either tell the legislature to enact the rollout or wait. Waiting would get a federal judge involved, who would tell the state to do what it's mandated to do.
"I feel like it's not just a bad business decision for the state in terms of giving up a lot of revenue and also our taxpayers' federal tax dollars are going to Medicaid expansion in other states now," Franklin said, "But I think it impacts the workforce in the Kansas City region directly."
The full senate will discuss the budget and whether to include money for Medicaid expansion next week.
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