Biden administration hopes Missouri’s Medicaid expansion will flip other holdout red states

Secretary of Health and Human Services Xavier Becerra answers questions at a Senate Health, Education, Labor, and Pensions Committee hearing to discuss reopening schools during COVID-19 on Capitol Hill on Sept. 30. Greg Nash/Pool/Getty Images/TNS

WASHINGTON — About 17,000 Missourians have applied for Medicaid since August under expanded eligibility rules, the U.S. Health and Human Services department said Monday morning.

Last Friday, Missouri’s Department of Social Services began processing applications for the state health insurance program under the new eligibility rules. With expansion officially underway after nearly a year of funding uncertainty and a court battle, the Biden administration is hoping to persuade a dozen other Republican holdout states to expand eligibility, more than a decade after the option was created by the Obama administration. HHS released a statement urging Missourians to apply for the program.

For those who do end up qualifying, their health care costs will be covered retroactively, starting from the date they applied.

“This is a win for all Missourians who have fought long and hard to gain their rightful access to quality health insurance made possible through the Affordable Care Act,” HHS Secretary Xavier Becerra said. “As we celebrate Missouri’s Medicaid expansion, the Biden-Harris Administration will double down on our outreach efforts to urge the remaining twelve states to join the rest of the nation in ensuring access to health care during this critical time.”

Administration officials touted the $968 million the state will receive over the next two years in federal incentive dollars through the American Rescue Plan. So far, however, the promise of federal incentives does not appear to have swayed politicians in remaining states that have not expanded, including Kansas.

Last Friday’s application processing came three months after the July 1 start date designated by voters as part of an amendment to the state constitution. And that was only after a judge in August ordered officials to accept applications.

Still, Democrats and health care advocates celebrated the implementation of the plan extending state health coverage to about 275,000 low-income Missourians. Previously, non-disabled adults without children were largely excluded, eligible only if they earned no more than 22% of the federal poverty level, or about $5,800 for someone in a family of four.

Under expansion, those earning up to 138% of the federal poverty level — about $17,700 a year for a single person — can be covered.

Early enrollment numbers won’t be available until November, a DSS spokeswoman said Friday.

The program still must clear a funding hurdle in the Republican-dominated General Assembly during next year’s legislative session.

After refusing to expand the program for a decade, lawmakers this year balked at paying for the cost of the voter-approved plan and blocked the $130 million in state funds and $1.6 billion in federal funds from the current state budget. Under the Affordable Care Act, the federal government picks up 90% of the costs of expansion.

The budget votes prompted Gov. Mike Parson to drop the expansion until the courts ordered it implemented. Parson’s administration will need lawmakers to fully fund the program next year to avoid Medicaid running out of money with the new recipients.

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