JEFFERSON CITY — Following the legislature’s decision not to fund Medicaid expansion, Gov. Mike Parson announced Thursday that the state would withdraw plans to add about 250,000 Missourians to the health care plan.

“Although I was never in support of MO HealthNet expansion, I always said that I would uphold the ballot amendment if it passed. The majority of Missouri voters supported it, and we included funds for the expansion in our budget proposal,” Parson said in a news release.

“However, without a revenue source or funding authority from the General Assembly, we are unable to proceed with the expansion at this time and must withdraw our State Plan Amendments to ensure Missouri’s existing MO HealthNet program remains solvent.”

Parson could have continued with expansion, with funding likely running out before the end of the coming fiscal year. At that point, a decision would have needed to be made about adding funding to the program.

The likely next step is a court challenge.

In August, Missouri voters approved a state constitutional amendment expanding eligibility in MO HealthNet — the state’s Medicaid program — to individuals between 100% and 138% of the federal poverty level.

The voter-approved expansion would have made Missouri the 38th state in the country to expand Medicaid coverage through the Affordable Care Act. Under the ACA, the federal government funds the vast majority of costs related to expansion, with states liable for only a small portion.

Republicans in the state legislature, however, have moved to block the expansion by declining to pass the legislation needed to fund it, effectively nullifying expansion.

They have provided various reasons for the move, including saying the August 2020 vote was not representative of the will of Missouri residents at large and that voters did not understand the implications.

Democrats have routinely disputed that characterization and cast Republicans’ unwillingness to fund expansion as a rejection of the will of Missouri voters.

Rep. Crystal Quade, D-Springfield, said Parson was breaking his promise to Missouri voters and violating his oath to uphold the constitution.

“Whatever reputation he once had for respecting the law is gone forever, and he is just another politician whose word can’t be trusted,” said Quade, the House minority leader. “Medicaid expansion will still happen as the constitution requires, but because of the governor’s dishonorable action, it will take a court order to do it.”

Rep. Peter Merideth, D-St. Louis, who has been a frequent and vocal critic of the effort to halt expansion, said Thursday that he was furious with Parson’s decision.

“I was upset when the legislature decided not to fully fund it, but I am far more upset now that the governor is deciding to ignore the constitution completely,” Merideth said.

Sen. John Rizzo, D-Independence, characterized Parson’s decision Thursday as the governor bending to the will of Republican legislators who don’t support Medicaid expansion.

“The Constitution says Medicaid Expansion happens on July 1,” Rizzo said in a statement. “There is more than enough money in the budget to implement expansion. This is the Governor caving to the new Authoritarian Republican Regime that doesn’t respect the outcome of elections.”

Crystal Brigman Mahaney, communications director for Missouri Jobs with Justice, called Parson’s announcement a “cruel and misguided decision.”

In a statement, she said Parson “promised Missourians for nearly a year that he would honor and uphold our vote and implement the constitutionally required expansion of Medicaid on July 1. Today, he chose to make all those promises a lie.”

Sara Dingmann of the Missouri News Network contributed to this report.

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

  • Assistant city editor, fall 2021. Former state government reporter, second-year graduate student studying public policy journalism. You can reach me at, or in the newsroom at 882-5720.

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