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A few different bills relating to MO Health Net are under consideration in Missouri’s legislature in the 2018 session.SB713 would expand Medicaid eligibility to include adults with income up to 138 percent of the poverty level, as called for in the ACA, with an effective date of January 2019.
Most able-bodied people with Medicaid coverage are already working, or face significant barriers to employment (such as lack of transportation, lack of affordable childcare, lack of dental and medical care to treat conditions that may prevent the person from working, etc.).
Former US Navy SEAL Eric Greitens (a former Democrat, now a Republican), won the election, and is opposed to Medicaid expansion because of the cost to the state.
Greitens continues to cite what he calls an “explosion” in government health care spending in the state, but health care experts in Missouri note that the spending growth has actually been fairly modest.
B.70, introduced by Senator Jill Schupp (D, 24th District), called for the expansion of Medicaid as called for in the ACA, effective January 2018. Vermont and Rhode Island have global waivers, but neither is a block grant (here’s more about Vermont’s, and here’s more about Rhode Island’s).
The bill did not advance, which wasn’t surprising, given that Republicans control the Missouri legislature, and that Donald Trump’s win emboldened their rejection of the ACA — including Medicaid expansion. B.28, introduced by Senator David Sater (R, 29th District), called for Missouri to submit an application to CMS for a “global waiver” for Medicaid, which would allow the state to receive Medicaid funds under a block grant, rather than the current open-ended matching system that the federal government uses. A global waiver requesting a block grant structure would have been extremely unlikely to be approved under the Obama Administration, but could potentially be approved under the Trump Administration.
The legislation calls for a variety of exemptions, including for people who are disabled, younger than 19 or older than 64, pregnant, caring for a minor child or disabled dependent.