Medicaid Cuts Looming: Missouri Residents Remember the Last Time
As the specter of significant federal cuts to Medicaid looms, many Missourians are haunted by memories of the last time the public medical insurance program was squeezed for cash in the state. Back in 2005, Missouri was grappling with budget shortfalls totaling around $2.4 billion over several previous years. In response, the state adopted some of the strictest eligibility standards in the nation, reduced benefits, and increased patients’ copayments for the Medicaid program. The result? More than 100,000 Missourians lost their coverage, leading to adverse financial consequences for many individuals and families.
One woman, working a $6.70-an-hour job at McDonald’s, found herself ineligible for Medicaid despite supporting three children on a meager income. Another woman, receiving $865 a month in disability payments, expressed concerns at a town hall meeting about being unable to care for her orphaned granddaughter while also meeting the state’s demands for increased payments to maintain her health coverage.
Fast forward to the present day, and Missouri could face an estimated loss of $2 billion in federal funding annually as congressional Republicans explore cuts of at least $880 billion over a decade from Medicaid programs nationwide. Medicaid and the Children’s Health Insurance Program collectively provide coverage for approximately 79 million Americans, constituting about 1 in 5 individuals in the country.
Amy Blouin, president of the progressive Missouri Budget Project, warns of a potentially more significant impact compared to the cuts experienced in 2005. She emphasizes the potential vulnerabilities faced by children and individuals with disabilities if federal funding is slashed.
The proposed cuts could have varying effects on different states, with estimates suggesting losses ranging from $78 million a year in Wyoming to $13 billion a year in California. State lawmakers would then be tasked with addressing these shortfalls, likely through measures such as benefit reductions, eligibility changes, tax hikes, or cuts to other significant budget items like education spending.
Republican lawmakers have put forth several proposals to trim Medicaid funding, including reducing federal support for adults covered under the Medicaid expansion provision of the Affordable Care Act. This provision allowed states to expand Medicaid eligibility to cover more low-income adults, with the federal government covering 90% of the costs for this group. Approximately 20 million people nationwide are now covered through this expansion.
Missouri expanded its Medicaid program in 2021, providing coverage for over 329,000 individuals who were previously ineligible. However, any cuts to federal funding could result in annual losses of $30-35 million for the state. Moreover, Missouri’s Medicaid expansion was approved through a constitutional amendment, meaning any changes to the program would necessitate another vote by the state’s residents.
In Crestwood, Sandra Smith worries about the potential impact of Medicaid cuts on her daughter Sarah, who requires round-the-clock care due to a rare genetic disorder. Medicaid covers in-home nursing services for Sarah, enabling her mother to work and maintain some balance in caregiving responsibilities. Losing this crucial support could have devastating consequences for the family.
Elias Tsapelas, director of fiscal policy at the Show-Me Institute, believes the extent and timing of budget cuts will influence the changes to Medicaid programs. Immediate and substantial cuts would force states to rapidly identify areas for budget reductions, while gradual adjustments could offer more flexibility.
Despite the political divide, a majority of the public, including a significant portion of Republicans, opposes major federal funding cuts to Medicaid. Missouri Senator Josh Hawley has publicly voiced his opposition to cutting Medicaid benefits, reflecting broader sentiments among constituents.
As U.S. House Republicans aim to pass a budget by Memorial Day, the fate of Medicaid funding remains uncertain. Missouri lawmakers are also considering a tax cut that could further strain the state’s finances. The implications of potential Medicaid cuts are profound, underscoring the critical importance of accessible healthcare for vulnerable populations in Missouri and across the nation.
