Despite an all-hands-on-deck effort by hospitals and our partner stakeholders, the Missouri Senate defeated attempts to include direct funding for Medicaid expansion in the budget on Wednesday night. Several Republicans joined the entire Democratic caucus in supporting expansion, and we are appreciative of their support.
Senate Majority Leader Caleb Rowden, R-Columbia, voted in support of expansion funding stating, “I think the question before us tonight is simply if we believe that we should fund the expansion that the people of Missouri voted on. And for me personally, the answer to that question is I think that we should.” In response to the argument that the districts represented by some senators voted against expansion, Sen. Lincoln Hough, R-Springfield, explained that, “We don’t write a budget for individual districts, we budget for the whole state. We budget for over 6 million people.”
However, the final tally was 14 votes for, and 20 against, funding the program.
This is not the last word on the matter. In fact, Wednesday’s vote all but assures that the courts will adjudicate whether Missourians have a right to enroll.
Throughout the decade, MHA and hospitals from every corner of the state have advocated for expansion. During that time, all but 12 states have expanded the program. And, after the 2012 U.S. Supreme Court’s decision that the federal government could not compel expansion as envisioned in the Affordable Care Act, states took advantage of opportunities to innovate during the process. Unfortunately, the General Assembly has consistently rejected both expansion, and its increased flexibility to rebuild and reform Medicaid.
Last year, hospitals were among those supporting the effort to let the people decide. Missourians did what lawmakers had refused to do. As we hoped and expected, Missourians affirmed that expansion was the right thing to do.
Gov. Parson’s leadership — and our supporters in the Senate and House Republican caucuses — should be applauded. Medicaid expansion will be good for the state, but it is not an easy vote or issue for Republicans, given their colleagues’ fervent opposition. Oftentimes, doing what is right isn’t easy or expedient.
Since August, Gov. Parson has continued to move the process forward by taking the steps necessary to implement expansion as directed by the Missouri Constitution. This work should continue. Missourians created a right to enroll beginning July 1.
It is clear that the Missouri courts now will have a larger voice in determining the fate of health care access for low-income Missourians. Perhaps that is a good thing.
The image traditionally used to represent the courts, Lady Justice, not only holds scales as an indicator that cases will be weighed on merit, but she also is blindfolded. Her blindfold signals that justice will be applied without outside influence. As the decision heads to the courts, expansion remains possible.
Last year, Missourians decided this issue on its merits. The case for expansion in Missouri has strengthened since.
This may not be the optimal path, but it is an open path. Missourians need us to continue moving forward.
Senate Passes FY 2022 Budget
State Bill Requires State Approval To Drop Trauma Center Designation
CMS Issues Final Rule On 2022 Marketplace Coverage Standards
Updated COVID-19 Vaccine Dashboard Available
Analysis Links Cannabis Use Disorder In Pregnancy To Infant Health Problems
The Senate approved a fiscal year 2022 operating budget for Missouri government early Thursday morning. The $35 billion spending plan does not explicitly fund Medicaid expansion. The body rejected an amendment that would have added direct funding for the coverage expansion on a roll call vote of 14 yes, 20 no. However, the Senate’s plan includes a $1 billion Budget Stabilization Fund infused with federal pandemic relief money to insulate the budget from future program cost growth. The Senate’s budget also includes $50 million for payments to hospitals that experience losses from the conversion of MO HealthNet outpatient reimbursement to a Medicare-based fee schedule. The Senate and House must reconcile the differences in their respective budgets by May 7, the constitutional deadline for enacting a state budget for the upcoming fiscal year.
A state House committee held a hearing on legislation to require state approval for a system hospital to drop its state designation as a Level II trauma center. It would apply to hospitals in St. Charles, St. Louis and Jackson counties. A hospital’s application would involve assessments of the financial and patient transport implications, and approval would come from the Department of Health and Senior Services and the governor. Violation can invoke licensure actions and fines. MHA testified in opposition to the bill.
The Centers for Medicare & Medicaid Services issued a final rule on risk adjustment, patient cost sharing and other standards for its Marketplace coverage plans in 2022. The agency also released a press release and fact sheet. MHA will publish an issue brief on the final rule.
The interactive Vaccine Administration dashboard now is available with doses administered through April 29. This dashboard is accessible to authorized users of HIDI Analytic Advantage. If you need a user ID and password or have questions about accessing these dashboards, contact HIDI.
Recent studies have shown that the use of cannabis during pregnancy is rising, with some expectant mothers reporting using the drug to alleviate nausea and vomiting associated with pregnancy. Medical experts have expressed concern about these patterns due to the active component of cannabis, delta-9-tetrahydrocannabinol.
A new study of nearly 5 million live births recorded in California from 2001 to 2012 found that babies born to mothers diagnosed with cannabis use disorders at delivery were more likely to experience negative health outcomes, including preterm birth and low birth weight, compared to babies born to mothers without a cannabis use disorder diagnosis.
