Medicaid expansion backers say they have enough signatures for initiative petition

Supporters of expanding Medicaid in Missouri said they already have enough signatures to get their measure on the November ballot.

Despite pausing events for the foreseeable future because of coronavirus concerns, Healthcare for Missouri campaign manager A.J. Bockelman said in an email to supporters this week that they will be able to submit the required signatures by the state's May 3 deadline.

"Thanks to a strong and early start to voter signature collections, we will be able to submit the required number of valid signatures by the early May deadline," Bockelman wrote.

The campaign is seeking a constitutional amendment that would expand Medicaid health insurance access through Missouri's MOHealthNet program to adults making up to 138 percent of the federal poverty designation.

Petitions for constitutional amendments need at least 160,199 valid signatures to be placed on the ballot, including at least 8 percent of the number of people who voted in the last election for governor in at least six of Missouri's eight congressional districts.

The campaign started collecting signatures last fall, spokesman Jack Cardetti said in an email. It is not collecting signatures now and won't be collecting more signatures, but it will be able to submit the required number of valid signatures before May 3, Cardetti said.

Missourians for Healthcare, the campaign committee behind the ballot measure, had raised more than $3 million and spent more than $2.3 million as of its most recent report, filed Jan. 14. It had received $250,000 from Washington University in St. Louis and $500,000 from the Missouri Hospital Association.

Whether Missouri should expand its Medicaid program has been a contentious issue in the Capitol since the Affordable Care Act passed in 2010, and numerous efforts to expand it through the Legislature have failed.

Proponents argued it would give more people access to affordable health insurance, bring in more federal money for the state, and protect the precarious finances of Missouri's rural hospitals, of which seven have closed since 2014. Opponents argued the program is inefficient and expansion would cost the state money that would have to be taken away from other priorities, like education.

The Affordable Care Act expanded Medicaid eligibility to anybody with an income up to 138 percent of the federal poverty line, which is $17,608 for an individual. Missouri is among 14 states that have decided against expanding eligibility.

In Missouri, Medicaid is still mainly available to people with disabilities, seniors, children and their parents, with incomes up to 122 percent of the poverty designation. The amendment proposed by Healthcare for Missouri would expand that access to everybody with an income up to 138 percent of the federal poverty designation.

The amendment would also prohibit work requirements for Medicare recipients, something for which some Republican lawmakers have advocated. State Sen. David Sater, R-Cassville, proposed a constitutional amendment that would impose work requirements for some Medicaid recipients who are able to work.

That proposal sped through Senate committees in January but has not been brought up for debate. With coronavirus disrupting the legislative session, it's unclear if the Legislature could put Sater's proposal on the November ballot.

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