Legislative Column for Feb. 13, 2020
It’s been said that budgets are a reflection of values. How we spend our money reflects the things that are important to us. Or, as the Bible says, “Where your treasure is, there your heart is also.” As a member of the Senate Appropriations Committee, I am constantly impressed by what Missouri’s budget tells us about our values. Well more than a third of state money goes to take care of those in need.
The governor’s total budget request for 2021 anticipates spending $30.9 billion on state programs and services next year. About 45 percent of the budget will fund what can generally be described as social services. The actual Department of Social Services budget alone accounts for one-third of state spending. The governor has requested $10.2 billion for that one agency. The greatest part of that – 85 percent of the department’s spending – will go toward Mo HealthNet, which administers the Medicaid program in Missouri and pays the health care costs for children, the disabled and seniors. Another 8 percent of Missouri’s budget, some $2.5 billion, is allocated to the Department of Mental Health. The Department of Health and Senior Services gets another $1.5 billion, or five percent of the budget.
With more than $4 out of every $10 of state spending going toward caring for individuals – either health care costs, mental health services or other social service programs – it’s clear that the Missouri’s heart is with those in need. We are a compassionate people and our budget reflects that.
There’s no doubt there is a great need for social service spending. According to the Department of Social Services, about one-third of Missouri’s children receive health care coverage through Mo HealthNet or the State Children’s Health Insurance Program. But state support for those in need extends beyond these programs. The Department of Social Services also has food assistance and housing programs for low-income families and helps pay for utility costs, child care expenses and other needs of our poorest residents.
The governor’s budget people tell us that state revenue is expected to grow by about 2 percent in 2020. Meanwhile, he’s asking for a 6 percent increase in funding for the Mo HealthNet program. Think about that. The program that accounts for a third of the budget is growing three times faster than state revenues. This is the reality the Appropriations Committee must face.
The ever-growing demand for social services looms over every budget discussion. When other needs come before the Legislature – education, roads, law enforcement, prisons, conservation or environmental protection – these important and worthwhile programs must always be weighed against the demands of social services, particularly Medicaid. As federal mandates for Medicaid spending increase, these costs threaten to swallow an even larger share of the state budget.
Outside the halls of the Capitol, there is an effort underway to place an initiative on the ballot that would force the state to expand Medicaid coverage far beyond current levels. If this measures succeeds, I believe the challenge of delivering a balanced budget to the governor will become far more complicated. Medicaid expansion will surely require cuts in other programs Missourians currently enjoy.
Regardless of whether the Medicaid expansion initiative petition succeeds, the share of Missouri’s budget that goes to pay for social services will grow in the future. Whether that growth presents a challenge or a crisis is up to voters. Many of the discretionary programs that we fund today to care for those in need won’t survive increased Medicaid spending. Legislators will have to make tough choices. These decisions will not indicate a lack of caring. They are simply the result of too many demands on limited resources. We still value compassion. Our heart is still with people in need. But we can only do so much.
As always, I appreciate it when groups from around Missouri and from our community back home come to visit me at the Capitol. If you would like to arrange a time to come and visit me in Jefferson City, or if you ever have any questions, please don’t hesitate to contact my Capitol office at (573) 751-1882.