Initial Medicaid Implementation: Prior to the implementation of the Medicaid program, Missouri ran a medical assistance program through the Kerr-Mills legislation. This program provided hospital and limited prescription drug and dental benefits. Medicaid was signed into law in Independence Missouri, home place of President Truman. Missouri began their Medicaid program in through the legislature’s adoption of Medicaid in October of 1967. When the program began, Missouri had no program for the medically indigent. The state did extend benefits to child welfare beneficiaries and blind people using state dollars prior to these categories of eligibility receiving federal Medicaid reimbursement.
Key Medicaid Political Issues: Although the Welfare reforms of 1996 ended the link between Medicaid and TANF, the state maintained many of the eligibility criteria for low-income residents through 2005. In 2005 the state eliminated the benefits for adults unless they met the minimum categories of pregnant of blind as defined by federal law. In 2007 the state passed a law requiring the program to be known as MO HealthNet in addition to Medicaid. The state in recent years has implemented several more regressive policies designed to make Medicaid coverage more difficult to obtain and maintain for beneficiaries. In 2016 the state enacted a law that would penalize Medicaid patients for missed appointments. The state has been at the center of the debate surrounding the defunding of Planned Parenthood.
Medicaid Expansion Implementation: Missouri has not expanded Medicaid. The state had a Democratic governor (Jay Nixon) and a Republican legislature for a large portion of the period that Medicaid expansion was being discussed. In 2014 the legislature debated a measure to expand Medicaid coverage. The Chamber of Commerce and local groups including a coalition of faith leaders have been active in supporting expansion and have supported plans to expand via referendum.
General facts about Missouri Medicaid:
Medicaid program name: Medicaid/MO HealthNet
CHIP Program name: MO HealthNet for Kids
Separate or combined CHIP: Combination
Medicaid Enrollment: 933,000 (2018 estimate)
Total Medicaid Spending: $10.2 billion (FY 2017 estimate)
Share of total population covered by Medicaid: 15%
Share of Children covered by Medicaid: 33% (estimate)
Share of Medicaid that is Children and Adults: 73%
Share of Spending on Elderly and people with disabilities: 70%
Share of Nursing Facility Residents covered by Medicaid: 66%
Expansion state: No
Number of people in expansion: N/A
Work Requirement: No