Props to legislature Republicans, who have found a way to make their dismissal of democracy and refusal to fund the voter-approved Medicaid expansion even worse!
The party’s fringe-right, emboldened by the unconstitutional anti-expansion gambit, is now trying to ban regular Medicaid recipients from using the program to purchase contraception. That, however, is a violation of federal law, and while they might be able to get away with disobeying their own voters, Republicans won’t be able to avoid the consequences from Washington. If they pass a budget with the anti-contraception amendment intact, the state Medicaid program will likely be stripped of all federal funding, which, even without the major expansion bonus, covers about 2/3rds of the annual bill.
This does not please other, more budget-conscious and maybe slightly more humane Republicans, even if Missouri’s program has been unfathomably stingy with benefits — it cuts off families that make above 18% of the federal poverty rate (just $5800 for a family of four!) while dismissing all single, able-bodied adults. As such, the contraception amendment was left out of a budget bill when it hit the floor of the state Senate on Monday, which caused such a furor amongst the vampire fundamentalists that it was pulled soon thereafter.
It’s hard to fathom a more irresponsible and heartless stunt by elected representatives [than not funding expansion], but state Sen. Paul Wieland, R-Imperial, and a majority of his Republican colleagues have managed it. By prohibiting use of Medicaid funds to provide recipients with contraception, Wieland’s amendment attempts to overrule federal law with his own extremist views on the topic.
OK, one more:
The episode should stand as one more reason Missouri voters might want to reconsider continually giving power to a party that has repeatedly shown nothing but contempt for the will of the voters, the concept of competent governance and the very lives of their own constituents.
State Senate leaders claim they’ll eventually pass it without the puritanical contraception amendment and fund Medicaid expansion, too. What they’ll have to compromise on to do so almost too scary to contemplate — they’ve really dug in on this one with some explosive rhetoric in order to justify denying more than 230,000 working people health care.
“Rural Missouri said no,” said Rep. Sara Walsh, a rural Republican, said when the House voted the funding for Medicaid expansion down a few weeks ago, ignoring the more than one-third of rural voters who did vote yes. “I don’t believe it is the will of the people to bankrupt our state.”
Other GOP representatives have made similar arguments, all of which are enormously dishonest. Gov. Mike Parson’s budget anticipates a $1.1 billion surplus and $2.8 billion from the American Rescue Plan. The stimulus also offers Missouri a $1.15 billion windfall for expanding Medicaid, as the federal government will cover 90% of expenses for the first few years.
That it would actually make the state money is irrelevant, of course, when ideology dominates all decisions. Republicans are comfortable defying the will of voters, by the way, because they were able to sneak through a gutting of another previous ballot initiative, which would have taken way the GOP’s ability to gerrymander legislative districts.
“Because of term limits and because of the changes within the Republican Party, the fights that we end up having end up not being over policy or even politics,” says Shawn D’Abreu, the policy director at the nonprofit advocacy group Missouri Health Care For All. “It’s more about this sectarian identity that one party is really fully embracing that says that they have the divine right of kings to rule and governance doesn’t matter and any election that they lose doesn’t matter.”
There’s no public outcry against the expansion, either, even though other lawmakers suggest people were “tricked” into approving something that even redder states such as South Dakota and Utah have approved in recent years. D’Abreu suggests that it’s likely that even more than 53% of Missourians support the expansion, which was shunted on to a low-turnout primary election day after Republicans failed in a lawsuit to remove it from the ballot altogether. One recent poll has support now at 65%.
And with good reason: Missouri has had some of the stingiest Medicaid qualifications for years now, as I mentioned above. Under the expansion, everyone making up 138% of the federal poverty line would be covered.
If the Senate winds up also ignoring Medicaid in its own budget, there are a few other options that activists can explore.
“The reality that Medicaid expansion is in the state constitution, and so we have not only the high moral ground, but we have important advantages, both legally and ethically,” he says.
Should a final budget pass without expansion, lawsuits would follow almost immediately. There are also supplemental budgets that could be considered later on. The real issue isn’t whether those 230,000 Missourians will receive their health care starting on July 1st — the constitution now requires it — but how exactly it’ll be paid for.
If the legislature doesn’t fund the expansion this time around, the federal government won’t kick in that $1.15 billion, which means the state’s coffers will be drained much more quickly, giving Republicans cover to cut the program’s benefits in the future.
By the way, Republican State Rep. Rick Boeber is resigning after being accused by his adult children of physical and sexual abuse. His resignation statement, of course, makes no mention of these allegations, which have been under investigation for months. Instead, Boeber says “it has become necessary for me and my soon-to-be wife to relocate out-of-state to be closer to our extended families.” These are very upstanding people.
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