In the first two months since the state expanded Medicaid eligibility, nearly 25,000 Missourians have enrolled in the program. This brings Missouri’s Medicaid enrollment to the highest point in state history, with more than 1.1 million recipients of state-sponsored health coverage.
A growing Medicaid program is nothing new for Missouri. Enrollment has crept higher in each of the past 21 consecutive months, dating back to the beginning of 2020. In that time, the program’s rolls have ballooned by more than 31%. In fact, enrollment in every single eligibility category (adults, children, elderly, persons with disabilities, pregnant women, etc.) has grown significantly over the past two years.
Keep in mind that program enrollment is the single biggest driver of Medicaid costs, which is a big part of why I was so concerned about Missouri expanding the troubled program. Even before Medicaid expansion went into effect, our state already expected to spend more on the program this year than ever before. In total, the program cost more than $11.5 billion last fiscal year, which was nearly 37% of the state’s budget. This year it’s expected to eclipse $12 billion for the first time.
Of course, the Medicaid program has been severely impacted by the COVID-19 pandemic. In response, the federal government approved multiple relief packages that include supplemental Medicaid funding. But this federal “relief” is now contributing to the state’s continued program growth. One of the early relief bills, the Families First Coronavirus Response Act, included a provision prohibiting states from removing anyone from Medicaid coverage unless the recipient asked to be removed or relocated out of state. This means that Missouri’s Medicaid agency stopped checking whether those already enrolled in the program were still qualified to receive services. Unsurprisingly, enrollment has increased in every month since, and it’s unclear when the agency will be allowed to resume eligibility redeterminations.
As I’ve written before, it’s long past time for Missouri’s elected officials to take the steps necessary to reform the state’s Medicaid program. Rooting out unnecessary spending in the Medicaid program should have been a higher priority before expansion, but now that continued enrollment growth is all but assured, it’s a necessity. How much longer can state taxpayers afford to foot the bill for this runaway spending?
