Missouri House of Representatives Speaker Todd Richardson has been named the new director of the MO HealthNet Division of the Missouri Department of Social Services.
Richardson, R-Poplar Bluff, an attorney who cannot seek re-election because of term limits, will resign from the House and take the position Nov. 1.
He will receive a $225,000 salary to direct Missouri's Medicaid program, which covers nearly 1 million people.
Most of those covered are low-income children, pregnant women, elderly people and people with disabilities.
The search for a new state Medicaid director has been ongoing since 2017, according to staff with Gov. Mike Parson, whose cabinet Richardson will join. The state's Medicaid program has been without a permanent director since the end of 2016, according to the Associated Press.
The division has a $10 billion budget.
Richardson will begin by traveling the state, meeting with stakeholders and assessing staff within the division.
"We have an enormous challenge in front of us," Richardson said during a news conference Monday. "The growth in spending is affecting nearly every area of our state's budget. At the same time, our health outcomes with MO HealthNet are not what they need to be."
MO HealthNet represents about 35 percent of Missouri's budget and, of its $10 billion costs, about $2 billion comes out of the state's general revenue, he said.
While in the Legislature, Richardson helped pass numerous health care and budget reforms, according to a news release from Parson's office. He was the author of a 2014 voter-approved constitutional amendment to strengthen taxpayer protections in Missouri's budgeting process. As speaker, Richardson helped pass reforms to Missouri's Medicaid eligibility process and expanded health care access through telemedicine.
The two previous full-time directors of the health division were physicians.
Richardson said he will begin by engaging with the staff of MO HealthNet — about 220 people — as well as Medicaid partners, providers, lawmakers and beneficiaries. He'll spend 60 days meeting with the stakeholders to develop a road map for the program's future.
The mission, he said, would be to ensure a sustainable program, producing better health outcomes at an affordable price.
"To stabilize the MO HealthNet program, it requires a leader who has earned bipartisan respect of policymakers," Parson said.
The position requires full time dedication, and Missouri needs someone who will provide problem-solving skills to improve health care, the governor said.
"The reason I wanted Todd to be in this position is that he truly cares about Missouri," Parson said. "He felt like we should have done a better job on it in the past than we have. And he was willing to step forward to finish the job that some could say we partially started."
Social Services Director Steve Corsi said the governor's appointment of Richardson is a "bold step in the direction of stability and leadership for Medicaid."
Richardson's three main challenges in the role, Corsi said, are looking at sustainability for Medicaid statewide, examining rural health care and hospital closures, and the rising costs of Medicaid.
When asked about the possibility of Medicaid expansion, Richardson said the Legislature has looked at it several times and rejected it each of those times.
"My focus is not going to be on expanding Medicaid eligibility," Richardson said. "It's going to be how do we work with this existing population to improve health outcomes and how do we put it on the path to financial stability."
Richardson said the program needs to have a renewed focus on quality metrics and outcomes and that the state needs to make sure the money being spent creates good results.