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Missouri GOP Blocks Medicaid Expansion Approved by Voters Because Rural Citizens Voted Against It

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Republican legislators in Missouri have blocked a bill that would fund a voter-approved expansion of Medicaid. One legislator said she opposed the bill because only one in three rural voters supported the bill.

State voters approved the expansion in an August 4, 2020 vote by a margin of 53.2 to 46.7 percent. The vote added an amendment to the state constitution making Medicaid available to people between the ages of 19 and 65 as long as their income is at or below 138 percent of the federal poverty level. The expansion would cover an estimated 230,000 individuals and has a July 1 deadline for implementation.

The state House bill, rejected by Republicans, proposed paying for the expansion with $130 million in state funds and $1.6 billion in federal funds. However, 20 Republican legislators in the House Budget Committee opposed it as too costly. Comparatively, nine committee Democrats voted for it.

Urban and suburban voters largely approved the Medicaid expansion, as did was nearly a third of the rural voters. Without the roughly 102,000 rural voters who supported the amendment in August 2020, it would’ve failed.

Republican lawmakers in Missouri blocked a voter-approved bill to expand Medicaid eligibility and funding in the state. Republican state Representative Sara Wals said she opposed the bill because it hadn’t received widespread support in the state’s rural areas. In this photo illustration, a doctor with a clipboard approaches an elderly woman and her silver-haired partner who rests in a hospital bed with an oxygen mask on his face.
KatarzynaBialasiewicz/Getty

However, Republican state Representative Sara Walsh cited the amendment’s low support among rural voters as a reason to oppose its funding.

“Rural Missouri said no,” Walsh said, according to The Kansas City Star. “I don’t believe it is the will of the people to bankrupt our state.”

Republicans have claimed that the state’s Medicaid program is already strained by increased use during the ongoing COVID-19 pandemic. They have said that expanding it will cause it to fail.

State Representative Ed Lewis said that opposing the bill also makes sense considering that the 53.2 percent of voters who approved the expansion don’t amount to a majority of either the state’s eligible voters or its population, the Star added.

Some state Republicans, such as House Budget Committee vice-chair Dirk Deaton, characterized the expansion as providing medical coverage to younger adults who can afford their own healthcare. Deaton also claimed that the expansion would reduce the program’s benefits for the disabled and elderly.

Other Republicans have argued that ballot measures can’t force the legislature to spend money.

However, Democrats view the August 2020 vote as a citizen mandate. As such, they view Republican opposition to the expansion as a betrayal of their constituents’ wishes.

Democratic supporters have also argued that the expansion can be funded through the state’s higher-than-expected revenues. They’ve also pointed out that the COVID-19 relief bill recently signed into law by Democratic President Joe Biden contains $1.1 billion in funding specifically allocated towards expanding Medicaid.

The federal funds could also help the state’s rural hospitals and healthcare industry, Democrats added.

If the legislature doesn’t fund the expansion, it could set up a potential legal battle. Citizens affected by the lack of an expansion could accuse the state of violating its own newly added constitutional amendment.

The Liberty Buzz contacted Walsh for comment.

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