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MoHealthNet supplemental totals hundreds of millions; tobacco settlement decline forces GR replacement
Summary
Budget staff told lawmakers MoHealthNet (Medicaid) faces a supplemental of roughly $242 million in general revenue (about $1 billion total funding) for utilization increases. Because tobacco settlement receipts are declining, the state will replace roughly $27 million formerly used as state match with general revenue.
JEFFERSON CITY — Officials presented the MoHealthNet supplemental to the House Appropriations Committee on Jan. 21, describing increased utilization across physicians, pharmacy, nursing facilities and managed care that together create a multi‑hundred‑million‑dollar supplemental need.
Tony Bridal, deputy director for MoHealthNet, told the committee that about $242 million of general revenue is included in the supplemental (about $1 billion in total funding across federal and state matches) to cover utilization and rate changes. He described demographic trends (aging population) and utilization growth for nursing facilities and pharmacy costs as drivers.
Committee members also discussed the state’s use of tobacco settlement money as a prior source of state match. Hogg said tobacco settlement receipts are declining and the budget must replace about $27 million of lost tobacco trust funds with general revenue to preserve the state match needed to draw down federal Medicaid funds. "Because the tobacco settlement money is going down by $27 million, we need $27 million of GR to make our state match," Hogg said.
Members asked for a break‑out of how tobacco settlement receipts are distributed (statutory priorities include the Life Sciences Research Trust Fund and an early childhood fund) and whether those other allocations could be altered; Hogg said statutory changes would be required to reallocate those shares and that the tobacco money is distributed by statute in a set order.
What's next: staff said they will provide the committee with a detailed breakdown of MoHealthNet utilization drivers, the tobacco settlement receipts by statutory share, and the calculations used to arrive at the $242 million general‑revenue request.
