With key tax held hostage by Republicans, Missouri Medicaid chief warns of 'crippling' cuts

St. Louis Post-Dispatch (MO)

May 26—JEFFERSON CITY — The acting head of Missouri's Medicaid program predicted disaster for his agency Tuesday if state lawmakers don't renew a special tax that pays for much of the $11 billion program.

Kirk Mathews, a former member of the Missouri House who is now serving as the interim director of the Mo HealthNet program, said the lack of the tax could result in a massive meltdown in services to low-income enrollees.

"The existence of the program will be threatened by the end of the year. I cannot overstate the impact, the importance of that," Mathews told members of a panel that oversees Medicaid services.

In addition to potentially having to reduce reimbursements to medical providers, Mathews said it could affect the department's ability to meet payroll.

"It is crippling. The absence of the (tax) by the end of December would make it challenging to even pay our employees," Mathews said.

At issue is a procedural roadblock erected by two Missouri senators during the waning days of the legislative session.

Republican Sens. Paul Wieland of Imperial and Bob Onder of Lake Saint Louis blocked passage of the so-called Federal Reimbursement Allowance tax in an attempt to bar the use of Medicaid dollars for contraceptive purposes or Planned Parenthood.

Lawmakers adjourned May 14 without resolving the issue.

Like other states, Missouri has a voluntary tax on hospitals, nursing homes and other medical providers to help pay for medical insurance for low-income residents. The FRA paid nearly 80% of the Medicaid program last year.

Sen. Jill Schupp, D-Creve Coeur, who is a member of the oversight committee, urged Mathews to sound the alarm bell with the governor's office and lawmakers to get the tax back on track.

"It's serious and it's not something that should be used as a political football," Schupp said.

Mathews told the panel that Gov. Mike Parson must schedule a special session to get the Legislature to take action.

"It will require a special session. As of this date, I have no word from the governor that that has been called, or when, at this point," Mathews said.

House Speaker Rob Vescovo, R-Arnold, and Senate President Dave Schatz, R-Sullivan, both told the Post-Dispatch Tuesday that they have not been notified about any plans for a special session this summer.

The General Assembly is scheduled to return in mid-September for its annual veto session. Mathews said he believes that would not be too late to resolve the impasse.

"I think we would be OK," Mathews said, adding that waiting longer could wreak havoc on medical providers.

He added that the department is preparing for the possibility of losing access to the money generated by the tax.

"We are not cutting back now. But we are making contingency plans," Mathews said. "We understand the seriousness of it."

Problems getting the FRA tax across the finish line come as the Legislature and Parson failed to earmark money to pay for a voter-approved expansion of Medicaid, spurring the filing of a lawsuit last week.

Mathews told the panel that he was unable to discuss expansion plans because of the pending legal action. His silence was backed by Dr. Nick Pfannenstiel, who chairs the oversight committee.

"There are now ramifications of what can be discussed. We're going to have to sit and wait to see what happens in that process," Pfannenstiel said.

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