Medicaid funding still at risk in Missouri, amid epic bumbling and indifference

Just after noon Tuesday, Gov. Mike Parson agreed to call a special session to consider renewing the critical Medicaid tax. The session begins Wednesday.

But there’s still no deal on renewing that tax, and the unnecessary near-collapse of the effort to fund Medicaid in Missouri shows just how seriously lawmakers in our state take the well-being of those without resources. And how far they are willing to go to prevent public funding for some forms of contraceptives.

The state still faces either massive cutbacks in education spending, disability services, nursing home payments and even school transportation, or the collapse of Medicaid, directly endangering 1 million Missourians and indirectly hurting all of us.

This crisis was both predictable and avoidable. When Missourians elect a governor and a legislature more interested in partisan messaging and running for higher office than actual governance, calamities like this Medicaid standoff are inevitable.

And while they blame others, Republican leadership in Jefferson City can find those responsible for this mess by looking in a mirror.

The issue was extending the Federal Reimbursement Allowance program, known as FRA. For years, the legislature has approved a tax on hospitals to provide the state’s portion of its costs for Medicaid, the state-federal insurance program for the poor.

But this year, Republicans in the state Senate decided to play games with people’s lives, holding up renewal of the FRA until they could attach language prohibiting Medicaid from paying for some types of contraception.

Better to let the whole state suffer, apparently, than to OK payments for, say IUDs, which as St. Louis Mayor Tishaura O. Jones has pointed out, can be prescribed for serious health conditions that have nothing to do with avoiding conception.

As a result, lawmakers adjourned without renewing the FRA.

Parson said he would call a special session to extend the tax if everyone could agree on the contraception provisions. A deal was close, but a handful of state senators still balked, insisting the FRA should also ban Medicaid reimbursements to Planned Parenthood.

That risks the federal government’s Medicaid dollars, as even some Republicans said.

Talks dragged on. Monday, Parson set a deadline of noon Tuesday for an agreement. Without a deal, he said, there would be no special session.

With moments to spare on Tuesday, all sides agreed to begin a special session to consider the Medicaid tax. Without it — and remember, a bill still hasn’t passed — Parson would have to slice more than $700 million from the state budget, starting July 1, in order to prevent the complete collapse of Medicaid.

Amendments on Planned Parenthood funding and birth control will now be a part of the special session.

Gov. Parson enables Republican fringe elements

Monday, Parson bitterly denounced GOP senators who were blocking progress on the bill, and the special session.

“You and you alone will own this, and the devastating effects on Missourians and our economy, if the FRA is not extended,” Parson told reporters.

Well now. Who exactly is to blame for this embarrassment?

Extremist state senators bear most of the responsibility, of course. Their enthusiasm for linking must-pass legislation with right-wing causes hurts this state over and over again.

Let’s name names: Sens. Bob Onder of Lake St. Louis and Bill Eigel of Weldon Spring. Sen. Mike Moon of Ash Grove, who once cut off the head of a chicken to make a political point. Sen. Paul Wieland of Imperial. Sen. Rick Brattin of Harrisonville.

But Parson is also to blame. He repeatedly enables the fringe elements in his party to pursue message-only bills, such as the ludicrous and illegal Second Amendment Protection Act.

Now he expects these same conservative bullies to fall in line on Medicaid? Fat chance. You helped create this monster, Governor. Now it’s out of control.

And let’s not forget Parson’s wobble on Medicaid expansion, which also played a role here. Parson was against expansion, then for it, then against it again. That ambivalence gave lawmakers the room to not only reject Medicaid expansion (and the state’s voters) but regular Medicaid, too.

“We cannot allow narrow political interests to hold hostage vital health care funding and the success of our economy,” Parson said Monday. What? That’s precisely what conservative Republicans and Parson are doing now with Medicaid expansion — jeopardizing additional billions in federal spending in the process.

Consider this: Missouri has a bigger surplus than at any time in recent memory, yet it faced either massive cuts to essential programs or the collapse of Medicaid. The folly of this situation would be laughable were it not so dangerous.