Sen. Justin Brown’s Legislative Column for July 31, 2020

To Expand or Not to Expand – That Is the Question

Every day brings us a little closer to the end of the 2020 election cycle. I’m sure many of you are like me and are already tired of the political ads on the TV, the radio and even as you cruise through social media. While the November general election is still four months or so away, the August primary is right around the corner on Aug. 4.

Now, the primary doesn’t always get the attention the November election does, but it’s no less important. For one, any time citizens have the opportunity to make their voices heard at the ballot box, they should. As Americans, we should never take this right for granted. Additionally, the primary election directly feeds into the general election, so sitting out this election may mean losing some of your voice in November.

When Missourians go to the polls on Aug. 4, they’ll be asked to pick a ballot from one of the five established political parties in the state. Ballot in hand, they can make their pick of party candidates for various offices, with the winner going on to appear on the November ballot with all the other parties’ winning candidates. It’s worth mentioning that Missouri has an open primary system, so you do not need to be affiliated with a particular political party to vote using that party’s ballot. Additionally, if you would like to skip having to choose a party ballot altogether, you have the option to select a nonpartisan, issues-only ballot. That leads us into the other important part of this election.

You see, this August, Missourians will be choosing more than just whose names end up on the November ballot. They will also be deciding the future of the most expensive program in Missouri’s state budget: MO HealthNet, Missouri’s Medicaid program.

Appearing on the August ballot is Amendment 2, which asks Missourians whether they want to expand MO HealthNet through the Affordable Care Act. Currently, MO HealthNet provides health care coverage to children of families who earn up to three times the federal poverty level, Missourians who are blind and disabled and low-income pregnant women, while also supplementing Medicare insurance for many older Missourians. Expanding the program with a “yes” vote on Amendment 2 would see the state covering the health care costs for anyone age 19 to 64 years old who earns less than 133 percent of the federal poverty level, while a “no” vote keeps Missouri’s Medicaid program unchanged.

Our state already spends a significant amount of resources on the MO HealthNet program. In the state’s FY 2021 operating budget, the program is scheduled to receive more than $11.6 billion. That is almost a third of the state’s $35.2 billion operating budget. In my opinion, the total cost of the program can only go up if more people are added to the state’s Medicaid rolls. Proponents for expanding MO HealthNet argue that if Amendment 2 passes, the federal government would initially cover 90 percent of the additional costs. While Washington will initially pick up the tab for 90 percent, Missouri is still left footing the bill for the remaining 10 percent, which is likely to be no small sum. Additionally, Amendment 2 doesn’t provide a mechanism to pay for expansion, but I’m sure you can imagine where it’s going to come from.

As a member of the Senate’s Appropriations Committee, I’ve seen firsthand the financial impact the COVID-19 pandemic has had on our state. General revenue is down, and thousands of Missourians have applied for unemployment since the start of the pandemic. The long-term impact of the pandemic on Missouri’s fiscal health is still uncertain, but with the governor making withholds to the Fiscal Year 2021 budget, you can be sure we’ll be feeling it long after the August elections are over. Ultimately, I have deep concerns about what expanding an already massive program could mean for Missouri’s bottom line going forward should voters decide to pass Amendment 2.

Again, I ask Missourians to take some time and consider not only which candidates they’ll be supporting on Aug. 4, but also the fate of Medicaid expansion in Missouri. Elections are important, and I encourage everyone to go to the polls and make their voices heard.

It’s my honor to serve as your senator for the 16th District. If you have questions or need any assistance, please call my office at 573-751-5713 or log onto my webpage at for more information.