'Why We Need Medicare for All': GOP Missouri Governor Rejects Ballot Mandate for Medicaid Expansion

Missouri Gov. Mike Parson is facing sharp criticism after he announced he will not expand Medicaid despite voters' approval of such an expansion in a statewide ballot measure last year.

"This is beyond unacceptable that their cruel governor would go against the will of the people and withhold lifesaving care," tweeted Rep. Pramila Jayapal (D-Wash.). "This is a perfect example of why we need Medicare for All."

Missouri voters approved a ballot measure last August to expand the state program known as HealthNet to roughly 275,000 low-income residents—those earning less than 138% of the federal poverty level. The expansion was set to begin July 1.

In a Thursday statement reaffirming his opposition to expansion, Parson, a Republican, said he sent a letter to the Centers for Medicare and Medicaid Services to withdraw the plan to expand HealthNet because the Republican-controlled legislature didn't appropriate funding when it finalized the budget on May 7.

"Republicans dismissed the results of the ballot initiative," reported the St. Louis Post-Dispatch, "saying it did not include directions on how to pay for adding new recipients."

According to NBC News:

Expansion would have cost the state $130 million, but it would also secure a federal match of about $1.4 billion to pay for the program. The state would also get an additional $1 billion over the next two years to help implement the program after the Biden administration sweetened the deal for the minority of states that have refused expansion.

Joan Alker, executive director the Georgetown Center for Children and Families, suggested in a tweet that Parson's move was evidence of "the places [Republicans] will go to deny people health coverage," including efforts to "thwart the will of the voters" and "turn down extra federal money on offer which means the state can actually make money for two years to cover its citizens."

The Missouri Budget Project similarly rebuked Parson's move.

Amy Blouin, president and CEO the organization, said that "state after state has shown that Medicaid expansion is an economic benefit for states. Not only do states save money on existing health services, but federal funds from expansion create jobs and increase economic activity, generating additional tax revenue to fund the state's share of expansion. No state has had to raise taxes or cut services to pay for it."

According to Rep. Bill Pascrell (D-N.J.), Republican-led states are refusing to expand Medicaid "for no reason but spite for the ACA," and accused them of choosing to "cling to cruelty."

"Future generations will be stunned by Republicans that killed their own neighbors to spite President Obama and the ACA," tweeted Pascrell.

The governor's move is likely to draw lawsuits.

"Missouri's constitution is crystal clear: Medicaid expansion must begin on July 1," said Jonathan Schleifer, executive director of The Fairness Project, a groups that has advocating state-level ballot initiatives to expand Medicaid.

"Missouri voters had the good sense to guarantee healthcare for their neighbors in the state constitution so that lifesaving care would no longer be subject to the whims of partisan politicians," said Schleifer, referring to last year's vote.

Parson's announcement "that he intends to ignore the will of Missouri's voters and violate the state constitution makes this a matter for Missouri's courts to resolve," said Schleifer. He also expressed "confidence that litigation will result in Medicaid expansion beginning on time for the 275,000 Missourians who will be eligible for healthcare."

The likely legal battles, however, may be of little solace those Missourians, who, at least for now, are being denied access to healthcare coverage.

"Cancer patients cannot wait for legal battles to access the life-saving coverage that Medicaid expansion provides," Emily Kalmer,Missouri government relations director at American Cancer Society's Cancer Action Network, told the Associated Press.