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Newly eligible for Medicaid in Missouri? Lawmaker wants you to work for your health care

Jeanne Kuang, The Kansas City Star on

Published in News & Features

Parson has told lawmakers he wants to have the bill passed by Feb. 1. With two weeks remaining, it has yet to reach the House floor, or the Senate.

Smith has repeatedly raised concerns about the ongoing costs of the expansion, though Missouri currently enjoys record revenues. It is receiving about $2.7 billion in federal funds from the Rescue Plan. The state ended the fiscal year last July with a $1 billion surplus and expects to do the same this year.

Asked last week if he would commit to paying for the expanded program this year and next year, Smith told reporters lawmakers were "in a different landscape than we were in last year" with a court ordering enrollment.

He could not immediately be reached for comment Friday morning on his latest proposal to curb the expansion. The constitutional amendment he filed would bar the "expansion population" from Medicaid if lawmakers don't pay for the program any particular year, without touching other Medicaid recipients.

And it would require enrollees to work, participate in job training or job searching, or obtain an exemption in order to receive Medicaid. Missouri already has work requirements for welfare and food stamps programs.


Work requirements for Medicaid were encouraged by former President Donald Trump's administration, which approved the rules for a dozen states. Biden's administration has now been rescinding those permissions.

A Harvard School of Public Health study of Arkansas' requirements found that in the roughly 10 months the rules were in place before a federal court halted them in 2019, 18,000 recipients lost Medicaid coverage — about a third of those subject to the rules. Researchers found that few understood the rules were in place and that they did not increase employment among recipients.

If passed by lawmakers, Smith's proposal would go to a statewide vote.

Smith last year filed a bill to undo a different voter-approved measure, a proposal to repeal or slow down minimum wage hikes that Missourians approved in 2018.

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