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After rejecting Medicaid expansion, Missouri Republicans look to spend cash elsewhere

After rejecting Medicaid expansion, Missouri Republicans look to spend cash elsewhere

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Medicaid debate

House Budget Committee Chairman Cody Smith, R-Carthage, answers questions about Medicaid funding during debate on the House floor on Thursday, April 1, 2021. (screengrab)

JEFFERSON CITY — After refusing to set money aside in next year’s budget to pay for a voter-approved expansion of Medicaid, Republicans in the Missouri House took steps Tuesday to distribute the unspent cash on other items.

From directing $18 million to school transportation costs to sending an additional $88 million to nursing homes, the House Budget Committee reviewed how it will spend the $1 billion that Republican Gov. Mike Parson had earmarked for the expansion of the health insurance program for the poor.

The panel’s review came after last week’s decision to not fund the expanded Medicaid program that voters approved last August by a 53-47 margin, saying even with federal sweeteners, the addition of 275,000 Missourians was not sustainable over time.

The decision enraged Democrats, who said the GOP-controlled House was ignoring the will of the people.

Missouri House members argue on Tuesday, March 30, 2021, that their fellow representatives need to fully fund an expansion of Medicaid that voters approved in August 2020.

Similar sentiments were voiced in response to Tuesday’s hearing.

“House Republicans have deliberately created a false choice between expanded Medicaid and other services. It’s important to remember Gov. Parson’s budget recommendations cut ZERO dollars from other state programs,” the House Democratic Caucus tweeted.

The maneuver came as state revenue continued a steady recovery from last year’s pandemic-induced spring decrease.

State Budget Director Dan Haug said Missouri’s net general revenue collections increased for the year by more than 15% compared with the same time in 2020.

Through the end of March, individual income tax collections rose more than 16% for the year — from more than $5.25 billion in 2020 to $6.15 billion this year. Income collections saw a similar increase of 16.3% for the month.

Sales and use tax collections increased to $1.78 billion this year from $1.72 billion, a rise of 3.5%.

Corporate income and franchise tax collections are up by more than 36.5% for the year — from $337 million in March 2020 to $461 million by last month.

In addition to the state’s tax collections, Missouri has received billions of dollars in federal aid over the past year, giving Parson’s administration a robust cushion heading into the next fiscal year.

The Missouri House debated a plan to strip funding from the Medicaid expansion plan, which voters approved in August 2020. Here, Republican members explain some reasons to hold funding.

Rep. Cody Smith, R-Carthage, who chairs the House budget panel, said he wants to use the Medicaid money to address shortfalls in other state funding.

Along with school transportation and nursing homes, he is proposing to funnel $53 million to mental health care services and $61 million to in-home care of the elderly and disabled.

The plan also includes sending an additional $1 million to the state’s chronically underfunded public defender office.

Smith said the committee could vote to forward the proposal to the full House by as early as Thursday, but warned it could be next week before it is ready.

“This is still a work in progress,” Smith said.

It remains unclear, however, whether the House’s plan will be taken up in the Senate.

The Senate Appropriations Committee this week will begin reviewing the spending plan approved in the House. Republican leaders in the upper chamber say they have not made a decision on whether to put Medicaid expansion into the budget.

Parson has not said how hard he will push the Senate to include the funding he sought when he introduced his version of the budget in January.

The legislation is House Bill 21.(tncms-asset)2d606e06-9323-11eb-b0f5-00163ec2aa77[2](/tncms-asset)(tncms-asset)d3ea4578-9312-11eb-81bf-00163ec2aa77[3](/tncms-asset)

Kurt Erickson • 573-556-6181 @KurtEricksonPD on Twitter kerickson@post-dispatch.com

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