A trio of first-year state representatives from Greene County shared differing insights on Medicaid expansion at a legislative recap event this month.
While state Rep. Betsy Fogle, D-Springfield, said she supports expanding the public insurance program that provides health coverage to low-income families and individuals, Reps. Alex Riley, R-Springfield, and Bishop Davidson, R-Republic, both voted in March against the measure.
The three legislators also spoke at the July 16 Springfield Area Chamber of Commerce event about budgetary issues and their first-year experiences in Jefferson City.
“I ran for office for the sole issue of Medicaid expansion, and I’m not ashamed to say that,” said Fogle, one of only two Democrats representing southwest Missouri. “I would argue that Medicaid expansion is the right thing for our state. It brings health care to individuals who are working but just fall in that gap.”
Missouri lawmakers passed a $35 billion budget in May that did not include funding for a Medicaid expansion approved by voters in August 2020. Amendment 2, the Medicaid expansion ballot initiative, was passed last year by a roughly 53% margin statewide. Opponents have said the state cannot afford to expand the program.
The issue is being decided in court. Cole County Circuit Court Judge Jon E. Beetem ruled June 23 that the voter-approved initiative was unconstitutional because it didn’t include a way to pay for 275,000 new enrollees. Budgeters estimated the program would annually cost the state $120 million. Attorneys for the plaintiffs, who include three women suing the state, appealed to the Missouri Supreme Court. The state’s highest court unanimously ruled July 22 the initiative didn’t violate the constitution.
The court ruled the Missouri Department of Social Services has appropriation authority to provide services for all individuals eligible under the expanded Medicaid program.
The case has been sent back to the circuit court to determine injunctive relief for the plaintiffs.
Riley said the matter is not as cut and dried as party affiliations might suggest. He said every representative has an internal struggle to decide if their first loyalty is to their district or to the state as a whole. For Riley, that meant voting against expanding Medicaid, which was counter to the majority of his constituents who voted on the issue in 2020.
“That’s one of the reasons why you saw Republicans in the House and the Senate reject Medicaid expansion is because they came from overwhelming areas of the state that told them that’s what they wanted them to do,” he said. “I came from a district that supported Medicaid expansion, so I know going in that was going to be one of the toughest votes for me politically to make. Philosophically, I have some real concerns with Medicaid expansion and just increasing the welfare state.”
Springfield City Manager Jason Gage was among those in attendance at the chamber discussion. While declining to state his position on the topic, Gage said he’s a strong advocate of following the constitution.
“We cannot have a situation in which the state constitution is not honored. I hope the determination provides the guidance that they need,” he said July 16 of the then-pending Supreme Court decision for the state legislature. “Sometimes the question is too specific really to a broader context and the guidance isn’t there.”
Fogle said if the court does rule in favor of Medicaid expansion, the state has billions of dollars sitting in its treasury that could pay for it.
“We did end the year with a record surplus in our treasury,” she said, noting she supports the need to have rainy day funds, which come from treasury reserve. “To me, what that means is we have money now that we can be investing in Missourians that would serve us well later on.”
According to figures released July 2 by the state Office of Administration, Missouri exceeded $11.2 billion in net general revenue during the fiscal year that ended June 30. The total was up more than 25% over last year and nearly 17% above the previous high of roughly $9.6 billion in fiscal 2019. The state general revenue fund held nearly $2 billion on June 30.
Davidson said caution is needed to not transfer general revenue money to the rainy day fund on programs that require spending on an ongoing basis.
“When considering how we spend surplus money, we really need to consider what are those one-time purchases that make the most difference and don’t create some sort of maintenance cost down the way,” he said.
The freshmen legislators all agreed their first year in the House of Representatives was a great opportunity to better learn the legislative process. Fogle and Davidson serve on four committees, while Riley is on seven, according to the House website. Both Riley and Davidson were among co-sponsors of House Bill 85, which prohibits state and local cooperation with federal officials that attempt to enforce any laws, rules, orders or actions that violate Second Amendment rights of Missourians. The bill was signed into law June 12 by Gov. Mike Parson.
Fogle, who didn’t get any of her sponsored bills passed in the House, said there were some disappointing days as a Democrat during this session.
“It was the most amazing experience of my whole life but also the most frustrating,” she said of serving in Jefferson City.
Fogle said her ability to get bills passed as a member of a super minority party is different than Riley’s and Davidson’s. It means she and other Democrats need to seek opportunities to work across the aisle.
“That reality is I’m a Democrat and the only one who flipped a district in the last legislative cycle. What that means for me is that my legislation does not move the way that my colleagues’ does,” she said. “I’m good with that. Our freshman year was a great learning opportunity for all of us.
“The thing that I learned is that if I want to get good work done, it means my name is not going to be on it.”
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