MO Medicaid Expansion in July 2021, Process Improvements Underway

MO HealthNet with 660K residents enrolled will be expanding next July to accommodate approximately 230K newly eligible residents thanks to 53% of voters approving Medicaid expansion in an August ballot initiative.  This is Amendment 2 to the state’s constitution and requires:

  • Full ACA-compliant Medicaid expansion to 133% of the federal poverty level (FPL),
  • No additional burdens or restrictions (such as work requirements),
  • The Department of Social Services and HealthNet Division to submit a state plan amendment (SPA) by March 1, 2021, to the US Centers for Medicare and Medicaid Services (CMS), and
  • Benefits to be available beginning July 1, 2021.

Missouri is the 38th expansion state (plus DC) and the sixth state to approve via ballot measure (ME was first in 2017, followed by ID, NE, and UT in 2018, and OK in June 2020).

The State partnered with Civilla over six months ago to streamline the application, interview, and verification process for safety net programs, which are lengthy and not always clear (individuals may need to complete over 60 pages of information and participate in an interview separately for each safety net program they wish to participate in).  Last week, Civilla suggested a pathway to spend the next 18 to 24 months implementing several process improvements, with the hopes that when Medicaid expands in July, it will already be much easier by then to apply, interview, and submit verification documents with much clearer and consistent communications.

IMA will continue to monitor regulator guidance and offer meaningful, practical, timely information.

This material should not be considered as a substitute for legal, tax and/or actuarial advice. Contact the appropriate professional counsel for such matters. These materials are not exhaustive and are subject to possible changes in applicable laws, rules, and regulations and their interpretations.

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