Missouri Medicaid Expansion Initiative (2018)

Missouri Medicaid Expansion Initiative
Election date November 6, 2018
Topic Healthcare and Welfare
Status Not on the ballot
Type State statute	Origin Citizens
List of Missouri measuresMissouri Proposition A - AugustMissouri Amendment 1Missouri Amendment 2Missouri Amendment 3Missouri Amendment 4Missouri Proposition BMissouri Proposition CMissouri Proposition DSubmit

The Missouri Medicaid Expansion Initiative was not on the ballot in Missouri as an initiated state statute on November 6, 2018.

The measure would have required the state to provide Medicaid for persons under the age of 65 and with incomes equal to or below 138 percent of the federal poverty line.

Overview

Obamacare and Medicaid in MIissouri

Medicaid is a government program that provides medical insurance to groups of low-income people and individuals with disabilities. The Affordable Care Act (ACA), also known as Obamacare, provided for the expansion of Medicaid to cover all individuals earning incomes up to 138 percent of the federal poverty level. In 2012, the U.S. Supreme Court ruled in NFIB v. Sebelius that the federal government could not withhold funds from states that refused to expand Medicaid. The ruling had the practical effect of making Medicaid expansion optional for states. In 2019, the federal government financed 93 percent of the costs of state Medicaid expansion. For 2020 and subsequent years, the federal government began covering 90 percent of the costs. As of 2017, 19 states, including Missouri, had chosen not to expand Medicaid.

Text of measure

Ballot title

The ballot title was as follows:

“

Do you want to amend Missouri law to: expand benefits under the MO HealthNet Program to any person age 19 to 64, who is not otherwise eligible, but who qualifies for MO HealthNet services under the provisions of the Affordable Care Act of 2010 ("Obamacare"), and who has income at or below 133% of the federal poverty level plus 5% of the applicable family size per federal regulation; and for the people covered under the expansion, require the reimbursement rate to MO HealthNet providers to be comparable to commercial reimbursement payment levels? State government entities estimate additional costs in excess of $2 billion annually. Revenues from the federal government to offset these costs are estimates to be $1.8 billion annually, subject to changes in federal law. Local government entities expect no costs or savings.

”

Full text

The full text of the initiative is available here.

Background

Medicaid expansion under the ACA

See also: Medicaid and Obamacare

The Affordable Care Act (ACA), also known as Obamacare, was signed into law on March 23, 2010. The ACA provided for the expansion of Medicaid to cover all individuals earning incomes up to 138 percent of the federal poverty level, which amounted to $16,394 for individuals and $33,534 for a family of four in 2016. The law was designed to provide 100 percent of funding to cover the new recipients for the first three years and to cut off federal Medicaid funding to states that chose not to expand coverage. However, the United States Supreme Court ruled in National Federation of Independent Business v. Sebelius (2012) that the federal government could not withhold Medicaid funds from states that chose not to expand eligibility. According to the Kaiser Family Foundation, this ruling had the practical effect of making Medicaid expansion optional for states. By January 1, 2017, 19 states, including Missouri, had chosen not to expand eligibility.

From 2014 to 2016, the federal government covered 100 percent of the costs of state expansion of Medicaid. In 2017, the total cost that the federal government financed decreased to 95 percent. The ACA was designed to decrease the amount the federal government covers to 94 percent in 2018, 93 percent in 2019, and 90 percent in 2020 and subsequent years.

The Affordable Care Act had not provided tax credits to adults with household incomes less than the federal poverty line because the law had aimed to cover these people under Medicaid. In states that did not expand Medicaid, many of these adults fell into a coverage gap in which they neither qualified for Medicaid nor for federal tax credits to purchase health insurance. As of 2016, around 2.6 million people fell into this coverage gap across the 19 states that did not expand Medicaid.

Adoption of Medicaid expansion under the ACA

As of 2017, 31 states and D.C. had expanded Medicaid under the Affordable Care Act (ACA), and 19 states had chosen not to expand Medicaid.

Path to the ballot

See also: Laws governing the initiative process in Missouri

In Missouri, the number of signatures required for an initiated state statute is equal to 5 percent of the 2016 gubernatorial vote in six of the eight state congressional districts. This means that the minimum possible number of valid signatures required in 2018 was 100,126. Signatures needed to be filed with the secretary of state's office six months prior to the general election on November 6, 2018. Six months prior to the general election was May 6, 2018.

On September 6, 2017, Gerald Peterson filed the initiative with Secretary of State John Ashcroft (R). The initiative was given a ballot title and cleared for signature gathering on October 16, 2017. Signatures were not filed for the initiative.

See also

Suggest a link

• Missouri 2018 ballot measures
• 2018 ballot measures
• Laws governing the initiative process in Missouri
• Obamacare overview

External links

• Initiative Petition 2018-275 (Missouri Medicaid Expansion Initiative)