Timeline unclear for $ 5.3 billion bill to support Missouri Medicaid expansion and state salary increases • Missouri Independent


Governor Mike Parson is in a hurry to secure a $ 5.3 billion expense bill passed on February 1, but it’s unclear when exactly the bill will reach the House floor for debate.

The House Budget Committee spent about five hours on Monday digging into the details of the bill that will fund Medicaid for the remainder of the year, give salary increases to state employees and distribute federal aid in pandemic cases in schools.

At the end, Vice President Dirk Deaton, a Noel Republican who chaired the hearing, said he was unsure when the committee would be called to vote.

“I would tell you the schedule, but I don’t even know it myself,” Deaton told the committee as he adjourned Monday night.

There are two rapidly approaching deadlines for passing the bill, one created by Parson for the pay rise and the other imposed by the needs of the Medicaid program.

In December, Parson offered to give all state employees a salary increase of 5.5% and to set a floor of $ 15 under all jobs in the state. The timing, state budget director Dan Haug told the committee, is that employees in nursing homes, prisons and other institutions across the state who will receive their last pandemic allowance funded by the federal government on Jan. 15 did not see a pay cut.

It is also intended to help the state compete in a tight labor market, he said.

“We are seeing some turnover in all areas and we are getting to the point where if we see more turnover, we will no longer be able to operate our state facilities,” Haug said.

The other is that Medicaid will likely run out of money by mid-February if no additional funding is provided, he said.

“A month to two weeks before we run out of money, we need to start sending letters to vendors telling them they won’t get their full payment,” Haug said.

The pay hike will cost $ 72 million, including $ 41 million in general revenue, along with additional funds to cover retirement and other costs related to pay rates. The Medicaid portion will cost $ 1.6 billion but will not require any general revenue.

Some of the additional costs relate to expanding Medicaid eligibility to cover anyone between the ages of 18 and 65 with income. less than 138 percent of the federal poverty guideline. The threshold is around $ 17,750 per year for a single person and $ 30,300 per year for a family of three.

But the $ 1.6 billion also covers unforeseen costs when budgeting, such as increased costs for prescription drugs or hospital care for people already on the program.

Republicans with a legislative majority have opposed expanding Medicaid eligibility under the Affordable Care Act 2010 for nearly a decade.

After supporters circled lawmakers to put the issue on the ballot, which was approved by voters in 2020, Republicans continued to fight it, refusing to include the funding in the current budget.

This sparked a trial and a Missouri Supreme Court decision that the initiative set eligibility standards for Medicaid; and that the state had no choice but to use funds already allocated to provide care.

On Monday, there was no attempt to renew this opposition. Haug and officials from the Department of Human Services told the committee that the money requested is for all Medicaid services.

When the ballot measure was passed, supporters expected about 250,000 people to register.

The Parson administration began accepting nominations on October 1 and, on Friday, 53,151 people have signed up. There are 69,000 other pending requests, officials said.

Committee members spent much more time questioning the timing and necessity of the salary increase. Some Republican members have questioned whether everyone who works for the state, including those who sit on top of agencies with significant salaries, should receive the pay raise. Others questioned whether $ 15 an hour was the appropriate floor for state wages.

The question is not whether the pay raise is necessary, said state representative Scott Cupps, R-Shell Knob. The question is whether giving it to everyone is fair.

“Is this the reality? Cupps said. “Have you ever seen a hungry dog?” Have you ever seen a big dog? Do they both need 5.5% more food to be in good shape? “

The tight labor market and rapid turnover of state employees at all levels are driving the rise in wages, Haug said.

The state’s job turnover rate was 26% last year, Haug said, and more than double, 55%, for employees earning less than $ 30,000 a year. An employee earning $ 15 an hour would earn $ 31,200 per year working full time.

For example, he said, the state has a prison, a youth services division, and a state mental hospital in Fulton. There is also a Dollar General distribution center in Fulton where employees can earn $ 17 an hour as a starting salary.

“We have the space and everything but the staff to open a service at (Fulton State Hospital) for people with behavioral health issues,” Haug said. “We hope the salary increases we are proposing will.”

About 8,800 state employees earn less than $ 15 an hour, Haug said.

The bill also begins spending funds allocated by Congress last March in the American Rescue Plan Act. These funds include $ 721.3 million for child care providers, including $ 444 million in grants to keep providers in business.

There is also $ 1.9 billion for schools, most of which is due to be allocated by March 24. Of that amount, 90 percent goes directly to local school districts.

The bill also includes $ 370 million in federal coronavirus funding for a variety of programs, including $ 100 million for the State Emergency Management Agency for Pandemic Response and $ 12 million to supplement the Crime Victims Act funds distributed to domestic violence shelters, child advocates and other victims. services.

On December 31, Parson authorized the state declaration of emergency for the coronavirus pandemic expire. The move came as hospitals across the state filled with patients sickened by the omicron variant and daily case totals set records.

This has led State Representative Peter Merideth, the committee’s ranking Democrat, to question why the state has not been able to meet testing shortages. The state’s provider for the free home tests, which must be ordered, shipped and then returned for lab analysis, only takes new orders on Wednesday and only a limited amount will be available each day.

This plan is not working, Meredith said.

“I have heard people who ordered them in December say they weren’t shipped,” he said. “Buy tests and give them to local health departments for people to come and get. “

But until the bill is passed, Haug said, the National Emergency Management Agency does not have the spending authority to do so or any other major action against the pandemic.


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