In my time in the legislature, large spending on Medicaid has been a recurring theme. Conservatives have been criticized by liberals for not expanding Medicaid under the ObamaCare scheme, but the truth is that our state cannot afford to expand Medicaid. In fact, just funding the current number of Medicaid recipients has been a yearly challenge as health care inflation far outpaces normal inflation and state revenue growth.
Over the last several weeks, the Senate Appropriations Committee has been hearing testimony about the 2017 Fiscal Year budget. During the committee process state departments lay out individual budgets, requesting funds to meet the perceived budgetary needs for the next fiscal year.
The new year’s $27.3 billion state budget is drastically impacted by funding requests from the Department of Social Services’ (DSS), which have increased to unsustainable levels that threaten the budgets of other state programs, departments and services. The Department of Social Services runs MO HealthNet, the state’s Medicaid program that provides health coverage to low-income Missourians. The 2017 DSS budget has increased at a very dangerous rate when compared to past years. Between fiscal years 2016-2017, DSS General Revenue funding has been recommended to increase by $395 million.
This is a huge funding request, with the large majority of it going toward Medicaid – over 98 percent is planned to go to Missouri Medicaid. Based on a 4.2 percent growth rate, overall General Revenue funding is expected to increase to $370 million, but the proposed state budget for DSS calls for a $395 million increase. This means $25 million in General Revenue monies will have to be taken from other state programs and services just to pay for an increase in this one department. Budget priorities like public education, higher education, and transportation are suffering because of out-of-control health care spending. Policy makers at the state and federal level have to work towards bending the cost curve for health care to solve this problem long term.
Welfare reform holds some promise for lessening the impact of Medicaid spending. In the past, under former Governor Matt Blunt, the state double checked the eligibility of Medicaid recipients and found that many individuals receiving Medicaid actually did not qualify for the program. Legislation moving through the General Assembly this year would allow for third-party verification of welfare eligibility and could help relieve the Medicaid rolls and save the state money.
I have long believed that able-bodied Missourians should be limited from welfare programs that often disincentive hard work and job seeking. The state must find a way to limit Medicaid spending’s impact on priorities like education and transportation – if we do not, then the state budget will eventually become a giant insurance program and our schools will suffer.
I look forward to passing a sensible and balanced state budget, but I am also working with my colleagues in the Senate for long-term solutions to budget issues like Medicaid inflation.
Thank you for reading this weekly column. Please contact my office at (573) 751-3678 if you have any questions.