Business Notes

Medicaid in Missouri

By Bryan A. Hollerbach

After protracted political wrangling, Medicaid in Missouri appears to be changing.

The U.S. Department of Health & Human Services defines Medicaid as “an assistance program serving low-income people of every age,” adding that the program “varies from state to state. It is run by state and local governments within federal guidelines.”

For residents of Missouri, Medicaid goes by the designation of MO HealthNet under the Missouri Department of Social Services.

According to the website of Missouri Secretary of State John R. Ashcroft, the August 4, 2020, primary ballots here proposed this wording for what was then designated Amendment 2:

“Do you want to amend the Missouri Constitution to: „ Adopt Medicaid expansion for persons 19 to 64 years old with an income level at or below 133 percent of the federal poverty level, as set forth in the Affordable Care Act; „ Prohibit placing greater or additional burdens on eligibility or enrollment standards, methodologies or practices on persons covered under Medicaid expansion than on any other population eligible for Medicaid; and „ Require state agencies to take all actions necessary to maximize federal financial participation in funding medical assistance under Medicaid expansion?

“State government entities are estimated to have one-time costs of approximately $6.4 million and an unknown annual net fiscal impact by 2026 ranging from increased costs of at least $200 million to savings of $1 billion. Local governments expect costs to decrease by an unknown amount.”

Ashcroft’s office subsequently reported that the amendment passed by 53.3 percent of 1,270,178 total votes.

For budgetary reasons, however, the Medicaid expansion, which reportedly will benefit an additional 275,000 Missourians, later stalled until a legal challenge, after which an Aug. 11, 2021, press release from Gov. Michael L. Parson stated: “In accordance with the Cole County Circuit Court’s Aug. 10 ruling, the Missouri Department of Social Services … will begin allowing individuals to apply for the MO HealthNet program under Article IV, Section 36© of the Missouri Constitution.”

That press release further quoted Parson as stating: “My administration is always going to follow the law, and yesterday’s court order is no exception. The necessary funding to cover the health care costs of the expanded population remains the issue. We will continue to work with the General Assembly and DSS to chart a path forward to comply with the court order and keep the MO HealthNet program solvent.” ln Missouri Department of Social Services, MO HealthNet Division, 615 Howerton Court, P.O. Box 6500, Jefferson City, 573-751-3425, dss.mo.gov/mhd