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Missouri budget finalized with extra Medicaid expansion funding in limbo

  • 4 min to read
Rob Vescovo, Cody Smith and John Wiemann address members of the press

From left, Speaker of the House Rob Vescovo, R-Arnold, Rep. Cody Smith, R-Carthage, and Speaker Pro-Tempore John Wiemann, R-O’Fallon, address members of the press during a press conference following the House’s adjournment Friday at the Capitol in Jefferson City. During the conference, Vescovo rejected the idea that Republicans’ votes against Medicaid expansion was political. “I think for some of our members, it’s a fundamental issue that they disagreed with,” he said. “And that was the ability we gave them to vote the way they felt was necessary.”

JEFFERSON CITY — House and Senate members gave final approval to a $35 billion budget brimming with federal cash Friday afternoon.

The only major argument about the budget was in regard to funding for Medicaid expansion, which remains in a state of uncertainty. The budget does not appropriate any funding toward its implementation, despite Missourians putting it on the ballot via initiative petition and passing it last year.

The budget includes $21 million in funding for the MO Excels grant and $80 million for institutions of higher education, adding a 3.7% increase in four-year universities’ core budgets. The funding also gives $10 million to community colleges and $10 million to MU’s NextGen Precision Health Institute.

Carter Templeton, a second-year law student at MU, monitors the Senate budget hearing

Carter Templeton, a second-year law student at MU, monitors the Senate budget hearing Monday, April 19, 2021, at the Capitol in Jefferson City. Templeton works in the Veterans Clinic, an organization that represents disabled veterans in compensation claims. The clinic is currently funded by doners, but this year the House included funding for it in the budget. “I’m here, hoping the Senate keeps it in,” Templeton said.

Sen. Greg Razer, R-Kansas City, said that he hopes the increase in higher education funding this session “is not an anomaly — that it becomes the standard … . I look forward to seeing that continue in years to come.”

“Last year — or the current fiscal year we are in — we are, as a state, contributing less to our higher education institutions than we did 20 years ago,” he said. “That's not adjusted for inflation; Those are real dollars. This current fiscal year, we are giving less to higher education than we did in 2001.”

The 3.7% increase became a flashpoint for some lawmakers due to the fact that it applies to the UM system, rather than to individual campuses. During a budget conference committee Wednesday, Sen. Lauren Arthur, D-Kansas City, suggested that the increase may not be equally distributed, according to Missourian reporting.

A crowd gathers opposite a screen

A crowd gathers opposite a screen streaming the Conference Committee on Budget on Wednesday at the Capitol in Jefferson City. Due to COVID-19 social distancing, seating inside the conference room was limited and attendees watched the livestream from just outside the room or streamed the committee meeting on their own phones or tablets.

Another university receiving funding is Harris-Stowe State University in St. Louis. A current student at Harris-Stowe, Rep. LaKeySha Bosley, D-St. Louis, expressed her appreciation for the additional funding it received. The legislature has resisted funding the state’s historically Black colleges and universities in the past.

“You know that they deserve more funding, but this is a step in the right direction,” she said. “I am excited about it, and I’m hoping that we can keep tradition from this day forward.”

The budget also appropriates $324 million for the Emergency Rental Assistance Program, $143 million for the Homeowners Housing Assistance Program, $10 million for a rural broadband grant program and $48 million for federal stimulus funds to cover the state's cost-share of overpayment of unemployment funds.

Mary Fox waits outside the Senate budget hearing

Mary Fox, director of the Missouri State Public Defender System, waits outside the Senate budget hearing Monday, April 19, 2021, at the Capitol in Jefferson City. The bill including funding for the public defenders system was HB 12. The committee was currently on HB 3. “I’ll be here for a while,” Fox said.

Medicaid funding, other priorities

The battle for Medicaid expansion funding has been fatiguing, stymied by a war among political parties which still threatens to derail any implementation plan.

Senate Democrats voted against the portion of the bill that contained line items for social services due to the lack of Medicaid expansion funding.

Rep. Cody Smith seen through the live view of a television camera

Rep. Cody Smith, R-Carthage, seen through the live view of a television camera, addresses the House floor Friday at the Capitol in Jefferson City. Smith is the chair of the House Budget Committee.

Democrats and other proponents of expansion have questioned the legislative intent behind not funding it, whether Republicans don't want to spend the money, or don't want to be seen as supporting the spending of the money.

The final budget contains around $1 billion dollars more than what Gov. Mike Parson requested at the beginning of the session, even without money for expansion.

At a press conference held after the final vote, Sen. Caleb Rowden, R-Columbia, expressed gratitude for lawmakers’ efforts to complete the budget on time.

Rowden, who voted in favor of funding expansion, said Parson has a choice to either freeze enrollment or go forward with expansion without the additional funds. If that happens, funding would run out before the fiscal year ends. Freezing enrollment could spark court action, while expanding enrollment means funds would run out before the fiscal year ends, because there would be more eligible enrollees but not more money.

Rep. Peter Merideth addresses members of the press

Rep. Peter Merideth, D-St. Louis, addresses members of the press during a press conference following the House’s adjournment Friday at the Capitol in Jefferson City. Merideth is the ranking minority member on the House Budget Committee. Merideth repeatedly brought up the lack of funding for Medicaid expansion on the floor, and immediately turned to it during his statement. “I, like I think most of our caucus right now, am just angry and I’m sad for the people of Missouri,” Merideth said. “The state GOP legislature, essentially, just gave them the middle finger today.”

“Obviously there’s a finite amount of money in the budget for Medicaid, and if he is trying to protect the existing population to kind of instigate that court case — that’s one path," Rowden said. "But he’s going to have to have some say in that one way or the other.”

“If the governor doesn’t freeze enrollment on the new population on July 1 when they are eligible,” he said, “there is money in the budget for those folks who enroll.”

During the Senate Democrats' press conference, Sen. John Rizzo, D-Independence, thanked President Joe Biden “and the Democratic majority in Congress who helped make this budget possible." 

From left, Jill Cremer, Jennifer Jordan and Shelley Woods of the Missouri Department of Elementary and Secondary Education

From left, Jill Cremer, Jennifer Jordan and Shelley Woods of the Missouri Department of Elementary and Secondary Education monitor the Senate budget hearing Monday, April 19, 2021, at the Capitol in Jefferson City. At the time, the committee was discussing a $2 million “public school improvement” line in the budget. “We’re here to address any questions that get asked of the department,” Woods said. “Unfortunately there’s not enough seating inside for everyone.”

The budget also includes funding for a number of projects, such as $9 million set aside for improvements to the Capitol Building — $1 million dollars of which will go toward replacing the carpeting in both the House and Senate. The decision is not something all lawmakers are happy about.

“I don't think Missourians want us spending the matching funds for what we spend on Medicaid on things like carpets in here when we're refusing to spend it on what they've told us to spend it on," said Rep. Peter Meredith, D-St. Louis, "and that's healthcare for more Missourians. That's jobs for more Missourians. That's what they told us to do with this money."

State senators and staffers rush back

State senators and staffers rush back into the conference committee room Wednesday at the Capitol in Jefferson City. The committee, made up of both senators and representatives, was formed this week to reconcile differences between the House and Senate budget bills.

With a week left in the legislative session, lawmakers are looking toward taking action on several remaining priorities, such as the "2nd Amendment Preservation Act," which states that any federal gun law or act deemed to infringe on Missouri residents’ right to keep and bear arms in accordance with the Second Amendment cannot be enforced by state law officers. Other pending laws seek to allow guns in churches and on public transit, as well as proposals looking to tighten voting rules and issue a state gas tax.

“I'd imagine that we’ll be playing a lot of defense next week. People will be looking at personal priorities and try to protect them in conference committees — pulling out bad stuff and finding bills that are palatable to the chamber,” Rizzo said.

Rep. Peter Merideth stands in the back of the House chamber

Rep. Peter Merideth, D-St. Louis, stands in the back of the House chamber Friday at the Capitol in Jefferson City. Merideth repeatedly brought up the lack of funding for Medicaid expansion in the state budget during the session, which was used to finalize a number of budget bills. “Boy, it’s hard to feel good about this budget today,” Merideth said.

Rep. Cody Smith answers questions from the press

Rep. Cody Smith, R-Carthage, answers questions from the press during a press conference following the House’s adjournment Friday at the Capitol in Jefferson City. When asked about a potential lawsuit resulting from the decision not to fund Medicaid expansion, Smith said, “What happens downstream of the legislative process is, you know, somewhat out of our control.”

Nikol A. Enyart, the acting fiscal manager for the Missouri State Emergency Managment Agency

Nikol A. Enyart, the acting fiscal manager for the Missouri State Emergency Managment Agency, watches the conference committee discuss the budget bill for the Department of Public Safety on Wednesday at the Capitol in Jefferson City. Due to limited seating inside the committee room, Enyart moved outside to watch the meeting be streamed on a nearby screen.

A lobbyist steps into the committee room for the Conference Committee

A lobbyist steps into the committee room for the Conference Committee on Budget on Wednesday at the Capitol in Jefferson City. For lobbyists and representatives from state agencies, the committee is their last chance to influence the budget before it is sent to the governor.

  • State reporter, fall 2020. Studying print and digital news. Reach me at asjbhx@umsystem.edu, or (573) 356-7458

  • Tristen Rouse is a statehouse photojournalist and a photo editor at the Columbia Missourian. He can be reached at tristenrousephoto@gmail.com or on Instagram @tristenrouse

  • Mark Horvit is the state government editor. Call me at 817-726-1621 with story ideas, tips or complaints.

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