COLUMBIA, Mo. (AP) — The Missouri Senate on Wednesday voted against paying to expand Medicaid as called for by voters last year.
The late-night Senate vote locked in the House's decision to refuse funding for the program, likely setting up a court battle with supporters of greater access to health care.
On her statewide tour last week, Kansas Governor Laura Kelly said it is important right now for the state legislature to take action on Medicaid. She said the federal government is offering to pay Kansas 350 to 450 million dollars in Rescue Plan money over the next two years if Medicaid is expanded.
The vote in Missouri on Wednesday divided Republicans and came after hours of sometimes-heated debate.
Several Republicans, including the Missouri Senate budget leader, argued that expanding Medicaid would obligate the state to pay for an expensive program that could mean a huge financial hit to the state's budget in the future.
“I'm sorry, if you're a healthy adult, you need to get a job,” said Manchester Republican Sen. Andrew Koenig, arguing that those newly eligible for Medicaid should instead get employer-based health insurance.
Democrats countered that many people who would get access to Medicaid are already working multiple jobs but still can't afford health care.
“We have a working class that cannot afford for-profit health insurance, and I’m one of those people, that could be one illness or one injury away from bankruptcy,” St. Louis-area Democratic Sen. Brian Williams said. “And those are people who go to work every single day.”
Some Republicans joined with Democrats in voting to pay to expand the program. They argued that lawmakers are obligated to fulfil the will of voters, who last year expanded Medicaid coverage eligibility to thousands more low-income adults.
Missouri’s Medicaid program currently does not cover most adults without children, and its income eligibility threshold for parents is one of the lowest in the nation at about one-fifth of the poverty level.
Former President Barack Obama’s 2010 federal health care law provides a higher-than-usual federal funding share for states that expand Medicaid coverage to adults earning up to 138% of the federal poverty level, about $17,600 for an individual or $30,000 for a family of three.
Missouri's new eligibility rules will take effect in July. It's unclear how lack of funding by lawmakers will impact that.