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Jan. 30, 2025 |  By: Rudi Keller - Missouri Independent

Missouri supplemental budget shows shortfall in Medicaid, education funding

kari monsees and dan haug in jefferson city

By Rudi Keller - Missouri Independent

Keeping Missouri state government operating through June 30 will cost $2.1 billion more than lawmakers budgeted last year thanks to lowballed spending estimates, sluggish lottery sales and new programs in education and other areas.

The election-year budget plan approved last year totaled $51.6 billion after Gov. Mike Parson was finished with vetoes that fell heavily on earmarked items inserted by legislators. While Parson was paring back on pork, lawmakers slashed spending in the Medicaid program to keep the topline total down.

New Gov. Mike Kehoe on Tuesday delivered his $53.7 billion budget for the coming fiscal year. It came with the supplemental spending request that took up most of a six-hour hearing Wednesday in the House Budget Committee.

The Medicaid program spent $12.6 billion on medical services in fiscal 2024 and billions more on mental health and other services. Lawmakers appropriated $13.6 billion for medical services the current year and Kehoe is asking for $15.8 billion in the year starting July 1.

The biggest item in the supplemental spending request is $942 million to cover a Medicaid shortfall. More realistic budgeting last year would have reduced that amount, MO HealthNet Director Todd Richardson told The Independent.

“They took about a 25% core cut last year,” he said.

The supplemental request is larger than last year, which was $580 million, but smaller than each of the three previous years, when federal pandemic aid and state employee pay raises inflated the totals.

Along with the new governor, the budget committee has a new chairman, state Rep. Dirk Deaton, a Republican from Noel. It also has a new vice-chairman, GOP state Rep. Bishop Davidson of Republic, who is also new to the committee.

Under state budget rules, lawmakers cannot add items to the supplemental budget but they can reduce or eliminate them. Deaton said it is too early to say whether the proposal will see major changes. 

“We’re still doing the due diligence, and we certainly need to take a look at it and make sure there’s the justification for it, and run everything through the traps,” Deaton said.

Davidson said he’s working to learn the jargon and the process for setting spending levels.

“We have a really awesome staff that are not only good analysts and good researchers, but they’re good teachers as well,” he said.

Major items in the supplemental request include:

In the early part of the hearing, State Budget Director Dan Haug and department leaders in attendance were often peppered with detailed questions about the budget lines. Later, as the hearing continued through lunch time, the time spent on each shortened.

And when Haug got to the Medicaid request, he even drew laughter.

“This is a page I probably should skip,” Haug joked when he reached the request. “It is only about a billion dollars.”

He received few questions about the request.

Lawmakers wanted to know why the lottery isn’t producing as much as promised last year. The budget included $430 million from the lottery for education programs, a 5% increase over the previous year. 

Instead, net proceeds available for education are down more than 15% during the first six months of the year.

Haug attributed part of the decline to a dearth of major jackpots, which draw ticket purchases from people who rarely play. State Rep. Louis Riggs, a Hannibal Republican, asked if video games that pay out cash prizes, which have infiltrated every corner of the state at convenience stores and other locations, were to blame.

“How much is that attributable to folks sitting there gorked out all day on those machines, which I don’t think we’re getting any tax revenue from, instead of playing the lottery?” Riggs asked.

Haug said there were no studies, so the answer is unknown.

“That could be a possibility but it is hard for us to quantify it,” he said.

Sometimes the questions focused on issues that weren’t addressed in the supplemental budget but are causing pain at home. The Department of Elementary and Secondary Education has struggled to implement a new payment system for child care vendors and in August promised to clear a staggering backlog by the start of November.

On Wednesday, Kari Monsees, deputy commissioner of education, said 70% of the backlog has been cleared and the target for clearing it is the end of February.

That wasn’t an answer that pleased the committee.

“When you have providers saying they are taking money out of their child’s savings accounts to keep their business open so we have child care, I have a problem with that,” said state Rep. Stephanie Hein, a Springfield Democrat.

The education agency took over the child care program when Parson reorganized state government and created the Office of the Child in the department. The department changed its software vendor in December of 2023, and both providers and families enrolling in the program began noticing issues tracking and receiving payment. Some child care centers closed and others turned away families using the subsidy program during months of missed payments.

There are backlogs of payments from before the changeover that must be met, said state Rep. Don Mayhew, a Crocker Republican. 

The plan for catching up payments only covers those made through the new software, he noted.

“It didn’t include the providers from the previous year who are stuck in this purgatory of old system versus new system,” Mayhew said.

When the committee finished with the supplemental plan, Haug gave a quick overview of the budget proposal for the coming year.

Kehoe is proposing a $200 million increase in the foundation formula, which covers the extra costs imposed by last year’s legislation, but balked at adding another $300 million that the formula shows would meet the full obligation to schools.

A key factor, the state adequacy target — a measure of how much schools that meet state standard spend — increased, driving the $300 million request.

“Just to be clear, we are not cutting funding to K through 12 education,” Haug said. “We are increasing funding by $200 million in K through 12 education, the largest increase they have gotten under this current formula, the largest increase we could find back to the 90s.”

Haug also discussed how Kehoe would keep his promise to eliminate the state income tax, which provides about 70% of state general revenue.

“I don’t think anyone here wants to cut 70% of state government,” Haug said. “There would have to be some revenue replacement there.”