COLUMBIA, Mo. (AP) — The Missouri Senate on Wednesday voted against paying to expand Medicaid as called for by voters last year.
The late-night Senate vote locked in the House's decision to refuse funding for the program, likely setting up a court battle with supporters of greater access to health care.
The vote divided Republicans and came after hours of sometimes-heated debate.
Several Republicans, including the Senate budget leader, argued that expanding Medicaid would obligate the state to pay for an expensive program that could mean a huge financial hit to the state's budget in the future.
“I'm sorry, if you're a healthy adult, you need to get a job,” said Manchester Republican Sen. Andrew Koenig, arguing that those newly eligible for Medicaid should instead get employer-based health insurance.
Democrats countered that many people who would get access to Medicaid are already working multiple jobs but still can't afford health care.
“We have a working class that cannot afford for-profit health insurance, and I’m one of those people, that could be one illness or one injury away from bankruptcy,” St. Louis-area Democratic Sen. Brian Williams said. “And those are people who go to work every single day.”
Some Republicans joined with Democrats in voting to pay to expand the program. They argued that lawmakers are obligated to fulfil the will of voters, who last year expanded Medicaid coverage eligibility to thousands more low-income adults.
Missouri’s Medicaid program currently does not cover most adults without children, and its income eligibility threshold for parents is one of the lowest in the nation at about one-fifth of the poverty level.
Former President Barack Obama’s 2010 federal health care law provides a higher-than-usual federal funding share for states that expand Medicaid coverage to adults earning up to 138% of the federal poverty level, about $17,600 for an individual or $30,000 for a family of three.
Missouri's new eligibility rules will take effect in July. It's unclear how lack of funding by lawmakers will impact that.
Senators on Wednesday also approved $48 million to spare Missourians who mistakenly received unemployment benefits during the COVID-19 pandemic from repaying the money. K-12 public schools are set to receive the full amount of funding called for in state law, and
The decisions came after a fight over allowing guns on public transportation, which temporarily derailed debate before being struck down.
Lake St. Louis Republican Sen. Bob Onder tried to amend the budget to strip public transportation funding unless buses and trains allowed people with concealed carry permits to ride.
But top Republican Sen. Dave Schatz struck the proposal down, saying it would violate rules against enacting policies through the budget.
That prompted Onder’s unsuccessful attempts to strip all $1.7 million in statewide public transportation funding, and another effort to eliminate funding only for public transportation in Kansas City, St. Louis and Springfield.
Onder said his efforts were not retaliatory, but intended to “send a message.”
“If you want to violate our constituents’ 2nd Amendment rights, their legitimate rights to self-protection, then you can forgo public money,” Onder said.
Both proposals were voted down by the Senate.