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‘It’s Just Incredibly Frustrating’: Voter-Approved Medicaid Expansion Now Faces Uncertain Fate In Missouri

State Rep. Peter Merideth speaks during a December 2020 debate on the House floor.
Tim Bommel
House Communications
State Rep. Peter Merideth, D-St. Louis, speaks during a December 2020 debate on the House floor.

Last August, Missouri voters approved a constitutional amendment that would expand Medicaid in the state beginning in July 2021. But this week, Republicans in the Missouri House declined to fund the program’s expansion, dropping it from the fiscal 2022 budget that is next headed to the Senate for input.

To colleagues across the aisle, including Rep. Peter Merideth, D-St. Louis, the GOP arguments in recent days against funding the change haven’t made much sense. And it’s not a battle Merideth anticipated when the current legislative session started — “especially after the governor came out very clearly stating that he intended to go forward with exactly what voters demanded and, frankly, what’s required by the constitution now,” Merideth, the ranking minority member of the House Budget Committee, said Friday on St. Louis on the Air.

“The budget that [Gov. Mike Parson] sent us included funding for expansion, and we thought, ‘OK, looks like this is finally going to go forward.’ We did start to get clues as the budget chairman started to signal in various ways that this fight was maybe not over yet, and sure enough, here we are.”

Amendment 2, the 2020 ballot initiative to expand Medicaid eligibility, drew 53.3% support from Missouri voters. It expands coverage beginning this July to low-income adults — anyone age 19 to 64 with an income level no higher than 133% of the federal poverty line ($17,600 for an individual and about $36,000 for a family of four in 2020).

But House Budget Committee Chairman Cody Smith, R-Carthage, has in recent days described Medicaid expansion as “wrong for Missouri” and “wrong for the state budget.” And Rep. Justin Hill, R-Lake St. Louis, called Medicaid expansion “a lie” and emphasized that, in his view, health care is not a right.

“I am proud to stand against the will of the people who were lied to,” Hill said during floor debate this week.

Merideth said on Friday’s talk show that those comments got his blood boiling.

“First of all, there was no big lie,” Merideth said. “But the people he’s calling liars are across the political spectrum. And it’s just incredibly frustrating to hear these complete lies about expansion while then calling Missourians liars and fools.”

The Democrat also expressed optimism that the Senate may fund Medicaid expansion in its version of the spending plan.

“I’ve talked to some of the senators on the Republican side of the aisle that think they’ll be able to pull this off,” Merideth said.

If the Senate wants to fund Medicaid expansion, the fight still wouldn’t be over; the budget would then go through a conference committee process to determine its final version. But Merideth said he’s hopeful the matter won’t end up in the courts.

“We all swear an oath to the constitution,” Merideth said. “I have to believe that will win out in this process. If it ends up in litigation that’s not going to start till July 1, and it’s just going to delay access for the 275,000 Missourians that are ready for affordable health care, to the health care industry that needs that influx of dollars, and to our economy.”

He pushed back against the GOP argument that Missouri can’t afford to expand Medicaid.

“The governor’s own budget showed we had the money to do that, and all of these other things that the budget chair is saying we can’t do,” Merideth said. “But the fact of the matter is … we have more money than we have ever had in our state right now, on hand.”

He added: “Even just from the [federal] funding for Medicaid expansion alone, that gives us an extra $2 billion for what they’re claiming costs us $100 million. We could cover that for 15 years without any impact on our state budget. And that’s if we didn’t see the cost savings and new revenue that every other state that’s expanded has seen.”

St. Louis on the Air” brings you the stories of St. Louis and the people who live, work and create in our region. The show is hosted by Sarah Fenske and produced by Alex Heuer, Emily Woodbury, Evie Hemphill and Lara Hamdan. The audio engineer is Aaron Doerr.

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Evie was a producer for "St. Louis on the Air" at St. Louis Public Radio.