Earlier this month, Missouri voters decided it was time for the state to expand Medicaid. Our state’s elected officials now have roughly ten months to iron out all the details before expansion goes into effect next July. With so many important decisions on the horizon, here are some questions for policymakers to consider.
What should Missouri’s version of expansion look like? States across the country have been given flexibility in implementing Medicaid expansion, and Missouri should take advantage of this. Seeking the appropriate federal waivers to tailor expansion coverage in such a way that it best meets the needs of Missouri’s recipients, while also protecting state taxpayers, should be a top priority.
What needs to happen prior to July 1, 2021? Expanding Medicaid will likely require significant changes to the current program. First, the state’s Medicaid agency will surely need additional resources to handle the extraordinary influx of new enrollees. At a minimum, this would include computer system upgrades and increased staff. In addition, state laws and regulations will need to be updated to accommodate the new expansion population.
What is the plan for covering the costs? One of the biggest concerns with Medicaid expansion is the cost and corresponding impact on the state’s budget. Policymakers will need to decide how to pay for the already skyrocketing costs of the current Medicaid program, while also figuring out how to budget for the potentially hundreds of thousands of new recipients. In such uncertain budgetary times, how Medicaid is funded could have significant impacts on other state funding priorities.
How will accountability be encouraged? Medicaid expansion will grow Missouri’s budget by billions of dollars over the next few years. It will be more important than ever that state taxpayers know how their money is being spent. Before the expansion proposal is implemented, policymakers should establish accountability metrics to help ensure each tax dollar is being put to good use.
Voters may seem to have the final say on a matter, but the passage of Medicaid expansion means we’re now entering the more complicated process of actually implementing the policy. Over the next ten months, our elected officials should carefully weigh every available option, because the decisions made will surely impact Missourians for years to come.
