It turns out there are still some grownups within the Missouri GOP — one, anyway. Gov. Mike Parson is laying groundwork for Medicaid expansion, as the state’s voters mandated last year, even though petulant legislative Republicans have refused to provide the funding for it. It will probably still fall to the courts to explain to legislators that, no, they aren’t allowed to just ignore voters’ decisions that they don’t like.
We have criticized Parson on many issues, including his long alignment with his party’s obstructionist refusal to expand Medicaid. But now that the voters have spoken, he is doing his job and carrying out their will. This is how democracy is supposed to work. The fact that most of Parson’s fellow Republicans in Jefferson City don’t understand that is disturbing.
When the Affordable Care Act (Obamacare) was created a decade ago, with the goal of providing something close to universal health care availability for Americans, expansion of the Medicaid system — the joint federal-state health care program for the poor — was to provide part of that coverage. But its architects underestimated Republican animosity toward Obamacare, which ran so deep that red-state leaders sacrificed the health of their own constituents to sabotage it. Missouri and other Republican-led states refused to expand their Medicaid programs, turning down billions in federal funds and undoubtedly costing lives in their quest to make sure Obamacare failed.
By last year, Missouri voters had had enough, and approved a referendum mandating expansion. Parson and the state’s other ruling Republicans did everything they could to stop it, including pushing the vote up from the November general election to the lighter-turnout primaries in August, which critics alleged that was designed to defeat it.
The measure passed handily anyway, promising medical coverage for some 275,000 low-income Missourians who were previously without it. With that outcome, the Legislature was effectively obligated to provide the necessary $130 million toward expansion — which would open a federal spigot for a total expansion of $1.9 billion. Yet Republican lawmakers refused, turning away hundreds of millions of federal dollars, leaving hundreds of thousands of vulnerable Missourians without coverage and inviting litigation.
The somewhat surprising postscript came Monday, when the Post-Dispatch’s Kurt Erickson reported that Parson’s administration had filed a proposed rule change needed to expand the program beginning July 1. In essence, the governor is proceeding with the process of implementing the mandated expansion even though the budget the Legislature sent him last week has no money for it.
Where it goes from here is an open question that will likely be addressed, ultimately, in open court. But Parson’s move is an indication that he, at least, knows when it’s time to admit a political battle has been lost, and bow to the will of the voters. The sooner that lesson gets through to legislative Republicans, the better.