Top Missouri Republicans say they have no intention of expanding Medicaid eligibility as a result of the Supreme Court's ruling on the federal health care law.
The high court struck down a provision Thursday that threatened states with the loss of existing federal Medicaid dollars if they refuse to expand coverage to adults earning up to 133 percent of the federal poverty level. That ruling essentially makes the expansion optional for states.
House Majority Leader Tim Jones says the Republican-led Legislature will not consider the expansion.
The state of Missouri is expected to get about $100 million dollars in additional Medicaid funds over several years under a federal program intended to encourage more home- and community-based services for the elderly and disabled.
Total Medicaid spending growth (dark blue) compared to state spending (light blue). In 2009 and 2010 state spending fell sharply as federal stimulus money came to the rescue. Now the reverse is happening.
During the Great Recession, as the ranks of poor and unemployed swelled, enrollment in Medicaid shot up, growing by 7.8 percent in 2009. At the same time, state tax revenues collapsed by nearly 17 percent. States couldn't afford to pay their share of Medicaid costs, and Congress came to the rescue with the Recovery Act, boosting federal Medicaid funding by around $103 billion. But the recovery dollars ran out in June, and now states are facing the biggest yearly increase in Medicaid costs in history, according to projections by the Kaiser Family Foundation. Missouri already spends over a quarter of the state budget on Medicaid.