By BRENT MARTIN
St. Joseph Post
Missouri voters approved expanding Medicaid under the provisions of the Affordable Care Act.
Missouri lawmakers refused to fund Medicaid expansion during the legislative session.
State Sen. Tony Luetkemeyer, a Republican from Parkville who serves on the Senate Appropriations Committee, justifies his vote against funding expansion, by stating those who put Medicaid expansion on the ballot in August failed to include a funding source.
“The Missouri Constitution is very clear that an initiative petition cannot be used to force an appropriation by the legislature absent a funding source,” Luetkemeyer tells St. Joseph Post. “And because there was no funding source that was included in the ballot language, there is no obligation by the legislature to fund it.”
Missouri voters approved the measure in August by a 53% majority. Voters in the metropolitan areas of Kansas City and St. Louis overwhelmingly favored the measure. Voters in rural Missouri overwhelmingly voted against it.
Sen. Dan Hegeman of Cosby, the Republican chair of the Appropriations Committee, characterizes his vote against expansion as a matter of standing up for the legislature.
“And I felt compelled to basically stand up for the legislative branch in defending our right to be able to appropriate funds in the state of Missouri,” Hegeman tells St. Joseph Post. “Otherwise, we’ll have all sorts of initiative petitions that come down with the next great idea that requires spending, but no revenue to go along with it.”
Not every Republican voted against expansion.
Republican St. Joseph state Rep. Bill Falkner says he voted to fund Medicaid expansion, because his legislative district voted in favor of the ballot issue.
Still, Falkner understands the resistance to funding expansion.
“It’s fine line, because if the courts rule that the state has to fund it then another initiative petition, can that be filed with a new program and they don’t have to have a funding source?” Falkner asks.
Also voting in favor of funding expansion was state Rep. Brenda Shields, a Republican from St. Joseph, who points out Missouri voters did approve the ballot measure. Shields also argues Medicaid expansion will more than pay for itself with a relatively small state expenditure to draw down a huge federal reimbursement: $126 million in state General Revenue to draw down $1.9 billion.
“I kind of follow the Missouri Chamber of Commerce belief that in the end Medicaid expansion will pay for itself,” Shields tells St. Joseph Post.
Shields expects the legislature to have to pay for expansion, eventually.
But, Luetkemeyer accuses those who put the issue on the ballot of being deceptive, purposely choosing not to include a funding source on the ballot.
“I think the reason they did not is because they knew they could not pass it if there was a tax associated with the ballot issue,” according to Luetkemeyer.
A lawsuit has been filed. The issue now rests with the courts.
Luetkemeyer expects the legislature to win a court challenge.
“I think it would be a dramatic act of judicial activism for any court in Missouri to say that the legislature is required to appropriate money when the Constitution very clearly says that the appropriation authority rests with the General Assembly,” Luetkemeyer says.
It’s not a sentiment shared by Shields.
“Brenda Shields ultimately believes that the courts will rule that we need to fund Medicaid expansion.”