With Missouri's legislative session ending May 15, a state senator from Rolla says he doesn't see Medicaid expansion occurring in the state this year.


With Missouri’s legislative session ending May 15, a state senator from Rolla says he doesn’t see Medicaid expansion occurring in the state this year.
Sen. Dan Brown (R-16th District) told The Rolla Daily News Thursday night after approving the state’s fiscal year 2016 budget, that while he believes the state will eventually move toward the direction of expanding Medicaid, the only way he sees that happening by being forced by the federal government.
Another way could be through a block grant program, similar to what happened in Rhode Island, in which that state took less federal dollars for its Medicaid program in exchange for more flexibility to run the program with fewer federal strings attached.
“I’m not being a just mean guy,” Brown said in response to his stance against expanding Medicaid.
During a candlelight vigil held April 20 in Rolla, in which nine people attended to show their support for expanding Medicaid, Missouri Health Care for All statewide grassroots organizer Crystal Brigman Mahaney said Brown was a “road block” to expansion and called on Brown “do the right thing and prioritize people over politics.”
According to Missouri Health Care for All, about 11,942 residents under the age of 65 living in Brown’s district were eligible for coverage under Medicaid expansion as of 2012.
Because the Supreme Court decided that Medicaid expansion under the Affordable Care Act would be left up to the states’ decisions, a coverage gap has been created in Missouri and other states that didn’t expand Medicaid.
Eligibility for Missouri’s Medicaid program is limited for low-income parents to those earning less than 19 percent of the federal poverty level. Under the ACA, Missouri could expand Medicaid eligibility to residents earning up to 138 percent of the federal poverty level.
However, children with a gross family income of up to 300 percent of the federal poverty level are eligible for Medicaid coverage now, so Brown questioned, with expansion if they should be cut back to 138 percent.
Brown also noted that if a state expanded Medicaid coverage, the federal government does not pay for the administrative costs of expansion.
Brown said for every “extra dime” that goes to fund the state’s current Medicaid program is money not going to education. He noted the state Legislature has been underfunding the foundation formula for many years.
The uncertainty of the ACA, as the Supreme Court decides a case regarding the federal exchange subsidies, which Missouri uses, also plays into the decision as to whether or not Missouri should expand Medicaid, Brown said.
“If you start this program, you just can’t take it away. That’s not done so easily,” he said.
Brown said the cost to just continue the Medicaid program in Missouri next year, not expand it, will be about $139.4 million more in the fiscal year 2016 budget than the fiscal year 2015 budget. Additionally, the state pays for pharmacy drugs for Medicaid consumers, and that cost will go up by about $108.6 million next year, Brown said.
“In one year’s time, that’s just the increase…and they (supporters of Medicaid expansion) tell me I don’t care? It’s not that I personally don’t want someone to have Medicaid coverage. I know just that this is what we can actually pay for and this falls on the shoulders of the taxpayers,” Brown said, noting that state’s social services budget has grown since he has been a state lawmaker.
Brown said he feels some supporters of Medicaid expansion only have half the facts and the facts are not as straightforward as they think.