Missouri Senate rejects Medicaid expansion

JEFFERSON CITY — By an overwhelming partisan 23-9 vote, Missouri’s Senate voted down the governor’s proposal to expand Medicaid to adults making less than 138 percent of the federal poverty level.

The proposed amendment was sponsored by Sen. Paul LeVota, D-Independence, and a former House Democratic leader.

Supporters argue that more than 300,000 Missourians would be added to the health-care program with federal government paying the complete cost in the first few years.

“It brings in money to our state,” LeVota said. “It expands the number of people who are covered and is the right thing to do.”

But the Senate Appropriations Committee chairman, Sen. Kurt Shaefer, R-Columbia, promptly rose to warn that eventually the state would be required to match federal funds and that money would end up getting taken out of the education budget.

“Does anyone really think that you can add three- to four-hundred-thousand more people on welfare and it not cost you any more or save you money,” Schaefer asked and then promptly answered his own question: “That alone is an absurd argument.”

The amendment was offered Wednesday to a measure that would require Medicaid recipients throughout the state receive their services through managed care systems.

The president of Missouri’s Chamber of Commerce blamed the defeat on failure to connect Medicaid expansion with broader changes in the system.

“Pure Medicaid expansion without responsible reforms is not a solution and will be a non-starter with Republican lawmakers,” Dan Mehan said in a written statement.

A package of changes in Medicaid was recommended by a Senate Medicaid interim committee, but that recommendation did not include Gov. Jay Nixon’s expansion call.

During the 2013 legislative session, there had been an effort by a House Republican — Rep. Jay Barnes, D-Jefferson City — to incorporate Medicaid expansion with a number of structural changes in the welfare program.

That approach, however, never got to a legislative vote after Senate leaders called the idea dead in their chamber.