A new report says Missouri's Medicaid costs could rise by 6.6 percent over 10 years if the state fully implements the federal health care law.
But the report also says almost half of that increase will occur even if Missouri does not expand Medicaid eligibility for adults.
The report by the Kaiser Family Foundation and Urban Institute says Missouri can expect to spend an additional $1.2 billion from 2013 to 2022 as more people join the Medicaid rolls because of the federal health care law.
In the wake of the Supreme Court’s ruling upholding the federal health law, Missouri Governor Jay Nixon is not taking a clear stance on whether he thinks the state should take part in a voluntary expansion of its Medicaid program. The health law originally required states to raise Medicaid eligibility to about 130 percent of the federal poverty level. But the Supreme Court ruling now leaves that decision up to states. Speaking to reporters in Kansas City Monday, Nixon said he hopes to work with providers, businesses, and lawmakers to figure out what’s best for Missouri.
After last week's Supreme Court decision upholding most of the Affordable Care Act, President Obama declared victory. But there was one major gray cloud -- or silver lining, depending on your point of view -- leaving open the question of Missouri's participation in the expansion of Medicaid envisioned by the federal health care law.
As part yesterday's Supreme Court decision on Obama's health care law, the justices ruled the federal government can't revoke states' Medicaid funding for failing to comply with the law's required Medicaid expansion. And as Véronique LaCapra reports, that could leave some Missourians without access to health insurance.
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.
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.
For people with chronic conditions, getting Medicaid services can be a confusing, disjointed experience, shuffling from provider to provider. Under a provision of the Affordable Care Act, states can apply for federal money to help coordinate that care. Missouri did just that, and the news came today that the state will be the first to get this kind of funding under the ACA. Missouri’s application was aimed at helping people with chronic mental health issues.