Parson moves up Medicaid expansion vote to August from November election

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Gov. Mike Parson gets his flu shot in October 2019.

Voters will weigh a citizen-led ballot measure on Medicaid expansion in August, after Gov. Mike Parson moved it up from the November election.

During Parson’s COVID-19 briefing Tuesday, the governor announced that he is placing Medicaid expansion on the ballot for the Aug. 4 primary election.

The group Healthcare for Missouri filed an initiative petition with the secretary of state to place Medicaid expansion on the ballot as an amendment to the Missouri Constitution, after the Republican-led Missouri Legislature resisted the idea of Medicaid expansion for years. Missouri is one of 14 states that haven’t expanded Medicaid eligibility under the federal Affordable Care Act, which provides billions of dollars more in federal funding to pay up to 90 percent of the cost if states choose to expand Medicaid, the program providing state-funded insurance coverage for people of low income, including children. The federal law allows the state to expand coverage to Missourians earning up to 138 percent of the federal poverty level, which translates to an income of roughly $17,600 for an individual or $30,000 for a family of three. An estimated 230,000 more state residents would receive Medicaid under expansion.

Boxes of signatures were delivered to the Missouri Secretary of State’s office in May, leading to the addition of Proposition B, a raise in Missouri’s minimum wage, on the Nov. 6, 2018 ballot. Over 120,000 signatures were collected by Raise Up Missouri. Photo by Erin Achenbach. (Photo by Erin Achenbach)

Backers say not expanding Medicaid is leaving money on the table that could be used for Missourians who need “life-saving” health care and to prevent rural hospitals from closing. Detractors say that once the federal funding eventually ends, the state will be left with the skyrocketing bill when current spending on Medicaid already increasingly dominates the state budget.

Following Secretary of State Jay Ashcroft’s certification of the petition last week, Parson signed a proclamation Tuesday to place the expansion initiative on the August ballot. Organizers behind the ballot petition had wanted to place it on the November general election ballot, in which Parson and President Donald Trump will both be up for election. But they said in a statement that they welcomed the change and that it could provide insurance coverage to Missourians sooner. 

“I want to be clear that this is about policy, not politics,” Parson said at the briefing. “At a time when our state is undergoing a major health, economic, and budget crisis, we need to know exactly where we stand on what would be a massive spending initiative for Missouri.”

The campaign for Medicaid expansion turned in twice the number of signatures required for the question to get on the ballot — 350,000 instead of the 172,000 needed to get on the ballot. The signatures took up 300 boxes.

When Ashcroft certified the petition for Medicaid expansion for the November ballot, the campaign committee behind the initiative, Healthcare for Missouri, issued this statement from campaign manager A.J. Bockelman: “We know access to healthcare is more important now than ever. Today’s certification is a testament to those from every corner of our state who came together to overwhelmingly place Medicaid expansion on the ballot so that 230,000 hardworking Missourians no longer have to choose between putting food on the table and being able to see a doctor. It’s more critical than ever that we bring $1 billion of our own tax dollars back from Washington D.C annually. so that we can keep rural hospitals open, protect thousands of health care jobs, and help essential workers access the care they deserve. Today’s certification is a tremendous first step forward in improving access to healthcare for Missourians.”  

According to research from Pew Charitable Trusts, Missouri is a top five state for general revenue spending on Medicaid. The state estimates it will need an additional $88 million in general revenue through Fiscal Year 2021 due to COVID-19.

“Pass or fail, it is important that we understand the implications of Medicaid expansion as soon as possible,” Parson said. “Placing the initiative on the August ballot will give us more time to prepare and account for the outcome in our state budget.” 

Following Parson’s announcement, Missouri House Budget Chairman Cody Smith said in a statement, “I applaud Governor Mike Parson for bringing this issue to a vote as soon as possible.  The COVID-19 crisis will require changes to our state budget.  We already face a difficult budget year and the budget difficulties would grow exponentially if the fiscally-irresponsible Medicaid Expansion passes.  We need a quick answer on the expansion issue so budget officials can get a better handle on the changes that must be made to keep the state’s budget balanced.”