Moves to Block Medicaid Expansion May Spell Trouble for MCOs

Across the country, conservative state officials are going further than ever to thwart Medicaid expansion, taking steps to reverse successful ballot initiatives, reforming processes to block ballot measures before they reach voters — and erecting barriers to Medicaid enrollment for some residents who are already eligible. That’s all potentially bad news for Medicaid-focused insurers, experts say.

In Missouri, voters in August 2020 approved an amendment to the state constitution that expands Medicaid. However, the Republican-controlled state legislature refused to fund the new program. Though Republican Gov. Mike Parson had promised to implement the expansion program as recently as January, on May 13 he reversed his position and sent a letter to CMS withdrawing the State Plan Amendments required to launch the program. In response, a Missouri legal aid group filed a lawsuit against the state.

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