House Passes Proposed Constitutional Amendment for Medicaid Eligibility

This week, the House gave first-round approval to a constitutional amendment that would go before the voters which would change eligibility requirements for MO HealthNet (Medicaid). HJR 117, sponsored by Rep. Cody Smith (R-Carthage), states that the General Assembly has the right to appropriate funds on an annual basis for the Medicaid expansion population (those who have incomes at or below 138% of the federal poverty level). It also states that Missouri shall not provide payments to hospitals that provide care to out-of-state residents. Finally, it requires Medicaid recipients to comply with work and community engagement requirements and allows a waiver to that effect to be sought every year until approved by the Centers for Medicare and Medicaid Services.

If approved by the voters, HJR 117 would repeal the constitutional amendment on Medicaid that was passed by 53% of the voters in August 2020. That amendment was challenged in court and in July 2021 the Missouri Supreme Court ruled unanimously that the state must begin enrolling the 275,000 newly eligible people for Medicaid without imposing further restrictions.

Proponents claimed that the proposed amendment would allow the General Assembly the flexibility to decide funding needs on a yearly basis. Opponents say the amendment disregards the will of the people and adds barriers for the state’s most vulnerable populations to access health care. The House will take one more vote on the bill before sending it to the Senate.