As of June 9, there have been more than 15,000 cases of COVID-19 and 800+ deaths in our state. A proposal to amend the state Constitution to expand eligibility for Medicaid is on Tuesday, Aug. 4, 2020s' ballot. Missouri had been one of 13 remaining holdout states that have already missed out on generous federal funding of the Medicaid expansion. Because of this, a federal judge put a stop to the work requirements. Missouri voters narrowly approve Medicaid expansion Aug 5, 2020 Voters were asked to amend Missouri's Constitution to force an expansion of Medicaid in the state. Budget Chair Cody Smith, R-Carthage, said that expansion created “a budgetary predicament” for Missouri, and that there will need to be extensive conversations about how to fund it. A University of Missouri School of Medicine study in 2012 concluded that “Medicaid expansion would be highly beneficial to the Missouri economy and its citizens.” And in June 2014, the Missouri Economic Research and Information Center announced that healthcare job growth in Missouri had slowed considerably since 2012, and was falling behind compared with states that had expanded Medicaid. Medicaid Expansion Makes Sense for Missouri. However, no Missouri Medicaid expansion exists, as the state did not accept the expansion. Arkansas was the first state to pass them in 2018. MO Medicaid Expansion in July 2021, Process Improvements Underway. As Kendrick alluded to, expansion comes with a 90/10 match from the federal government. Before the pandemic, if Medicaid expansion had been passed in Missouri, an estimated 200,000 Missouri residents would have been given access to health insurance. State Rep. Sarah Unsicker, D-Shrewsbury, is a proponent of expansion, but she said taking a closer look at and reforming the Medicaid program is past due. Missouri voters approved expanding Medicaid by about seven percentage points in August, and now it’s up to the state legislature to get a program in place during the 2021 legislative session, which begins next month. Parson did not support expansion, and in his State of the State address he called it a “tax increase Missourians could not afford.” But he said he will follow through on what voters agreed to. “I expect there will be voices who feel like there was no funding mechanism that was attached to the drafting of the amendment, so therefore the Legislature isn’t bound to pass it,” Coleman said. “It’s very unclear what the actual hard-dollar costs are going to be,” Coleman said. Learn about other ways to listen to Jazz KWMU-2 and Classical KWMU-3. Twelve states have not adopted the expansion, which funding from the Affordable Care Act made possible by covering 90% of the costs. Hatfield also pointed to Republican Gov. The legislative session is scheduled to begin Jan. 6, and Medicaid expansion is expected to be a major topic throughout. Now, Missouri will join most other states in expanding Medicaid to anyone earning up to 133% of the federal poverty level, which is about $17,000 a year for a single person. “Missouri’s ability to amend the constitution is pretty broad,” Hatfield said. The COVID-19 pandemic has had a devastating impact on the nation and the state of Missouri. It is estimated expansion of MO HealthNet, the state's Medicaid program, would add about 230,000 people to its rolls. Going against the will of the voters would not be new for the General Assembly. Missouri voters are deciding whether to expand Medicaid eligibility under the Affordable Care Act, which could extend health coverage to as many as 217,000 low-income people. She said it’s going to come down to money for the program, which she believes the state does not have without taking it from other areas, like education and transportation. Hatfield said the way the constitutional amendment was written means the Legislature funds the entire Medicaid program or none of it. Five states have expanded Medicaid by ballot Missouri is the sixth state run by Republicans to say yes to expansion, a provision of the Affordable Care Act, at the ballot box. This is Amendment 2 to the state’s constitution and requires: However, outgoing state Rep. Kip Kendrick, D-Columbia, the ranking minority member of the Budget Committee, said he does not anticipate the costs associated with expansion to be as high as some are suggesting. “Missouri spends a lot more on Medicaid recipients than most other states,” Unsicker said. This means 90% of costs associated with expansion are covered at the federal level, and states that have already expanded Medicaid have been able to offset some of their program costs to become a revenue generator for their budgets. Missouri voters approved expanding Medicaid by about 7 percentage points in August, and now it’s up to the Legislature to put a program in place during its 2021 session, which begins next month. Missouri voted to expand its Medicaid program, as 53% of voters supported the measure. State Rep. Mary Elizabeth Coleman, R-Arnold, said “everything is on the table” when considering how the program will look in Missouri. Jaclyn is the Jefferson City statehouse reporter for St. Louis Public Radio. 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