Federal Medicaid cuts could leave Missouri with huge budget shortfall
Proposed cuts to Medicaid being considered by the Republican-controlled Congress could create a massive budget shortfall in Missouri, the director of the state Medicaid program told lawmakers on Tuesday.
Todd Richardson, director of MO HealthNet, the state's health insurance program for low-income and disabled Missourians, told the Senate Appropriations Committee that the state could be on the hook for hundreds of millions of dollars in Medicaid costs under proposals being debated in Congress.
Roughly 70% of the state's Medicaid funding comes from the federal government.
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Richardson said that while his department is excited about some of the changes Congress is exploring, such as creating more flexibility for states to make Medicaid-related decisions, others will 'present a challenge.'
There are 'things that I think a state we would wholeheartedly embrace, and would be an exciting opportunity for us to have, but that's also got to come with the same level of financial commitment,' Richardson said.
'If not,' he told the committee, 'it's going to be a significant challenge for us and for you all to figure out.'
Under one proposal, the federal government would drastically reduce the rate at which it pays states for low-income Americans covered under Medicaid expansion.
Missouri expanded Medicaid eligibility in 2021, over opposition from Republican lawmakers, via a ballot measure. The state Supreme Court upheld the measure, and Medicaid expansion is enshrined in the state constitution.
State Sen. Lincoln Hough, a Republican from Springfield who chairs the appropriations committee, prompted the discussion by asking what the Missouri Department of Social Services is doing to prepare for potential federal changes.
'I did want to at least put it on the radar of the committee,' Hough said, 'that when people talk about changes at the federal level, there are pretty significant implications in what we're able to do here.'
Jessica Bax, acting director of the department, told senators that the agency will need to 'plan for everything that could possibly happen at the federal level, which is difficult to do.'
Republicans in the U.S. House have forwarded a number of proposals to slash Medicaid in order to help pay for $4.5 trillion in tax cuts pushed by President Donald Trump, along with other priorities including border security.
The U.S. House is expected to vote on a budget resolution this week.
The federal government currently pays for 90% of the cost of Medicaid for enrollees who qualify under Medicaid expansion. Those are adults who make up to 138% of the federal poverty level, or $21,597 for an individual in 2025.
There are currently over 348,000 enrollees in the adult expansion group in Missouri, making up around one-quarter of all Missourians on Medicaid — so any decrease in the federal match rate would have a significant effect on the state budget.
Richardson said the department estimates that it could cost the state between $30 million and $35 million for every percent decrease in the federal match rate, meaning even a federal decline from 90% down to 80% would cost between $300 million and $350 million.
One federal proposal would entirely eliminate the federal match for the adult expansion group. If the federal match rate were eliminated and Missouri kept covering the expansion population, KFF estimated, it would cost Missouri $7.3 billion.
Missouri's overall budget for the coming fiscal year is $53.7 billion, as recommended by the governor.
While other states could reverse their decision to expand Medicaid if the federal government drops the reimbursement rate, expansion is codified in Missouri's constitution, which would require another statewide vote to change.
Some Republicans have opposed cuts to Medicaid, citing the effect on their constituents. It's a popular program: According to a survey last year by the health policy organization KFF, 71% of Americans want Medicaid to continue as it is today.
That includes Missouri Sen. Josh Hawley, who told HuffPost last week: ''I would not do severe cuts to Medicaid.'
One in every five Missourians is enrolled in Medicaid. Nearly 40% of all Missouri children are covered by Medicaid.
Medicaid in the state pays for two-thirds of all nursing home care in the state, and 38% of all births.
There are several other proposals that have been floated by Congressional Republicans.
One is to impose Medicaid work requirements, which the progressive think tank Center on Budget and Policy Priorities estimated could put 445,000 Missourians at risk of losing coverage.
Another would shift the payment model to a block grant system, limiting states' flexibility to receive more reimbursement as costs rise. And it's not the only safety net program on the chopping block: the House Republican plan could also slash the federal food benefits program, Supplemental Nutrition Assistance Program, reducing federal spending by $230 billion over a decade.
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Hamilton Spectator
an hour ago
- Hamilton Spectator
Gabbard's claims of an anti-Trump conspiracy are not supported by declassified documents
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Those investigations either concluded — or accepted the conclusion — that Russia embarked on a campaign to interfere in the election through the use of social media and hacked material. The House-led probe, conducted by Trump allies, also concurred that Russia ran an election interference campaign but said the purpose was to sow chaos in the U.S. rather than boost Trump. Several of the reports criticize the actions of Obama administration officials, particularly at the FBI, but do not dispute the fundamental findings that Moscow sought to interfere in the election. The Associated Press has reviewed those reports to evaluate how Gabbard's claims stack up: Russian election interference CLAIM: 'The intelligence community had one assessment: that Russia did not have the intent and capability to try to impact the outcome of the U.S. election leading up to Election Day. The same assessment was made after the election.' — Gabbard to Fox News on Tuesday . The documents Gabbard released do not support her claim. She cites a handful of emails from 2016 in which officials conclude that Russia had no intention of manipulating the U.S. vote count through cyberattacks on voting systems. President Barack Obama's administration never alleged that voting infrastructure was tampered with. Rather, the administration said Russia ran a covert influence campaign using hacked and stolen material from prominent Democrats. Russian operatives then used that information as part of state-funded media and social media operations to inflame U.S. public opinion. More than two dozen Russians were indicted in 2018 in connection with those efforts. Republican-led investigations in Congress have affirmed that conclusion, and the emails that Gabbard released do not contradict that finding. Shift in assessment? 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Putin's intent CLAIM: The Obama administration 'manufactured the January 2017 Intelligence Community Assessment that they knew was false promoting the LIE that Vladimir Putin and the Russian government helped President Trump win the 2016 election.' — Gabbard on Truth Social Wednesday. The material declassified this week reveals some dissent within the intelligence community about whether Putin wanted to help Trump or simply inflame the U.S. public. That same question led to a partisan divide on the House Intelligence panel when it examined the matter several years later. Gabbard's memo released last week cites a 'whistleblower' who she says served in the intelligence community at the time and who is quoted as saying that he could not 'concur in good conscience' with the intelligence community's judgment that Russia had a 'decisive preference' for Trump. Such dissent and debate are not unusual in the drafting of intelligence reports. The Republican-led Senate Intelligence Committee examined whether there was any political interference in the Obama administration's conclusions and reported that 'all analysts expressed that they were free to debate, object to content, and assess confidence levels, as is normal and proper.' In 2018, Putin directly addressed the question of whether he preferred Trump at a press conference in Helsinki even as he sidestepped a question about whether he directed any of his subordinates to help Trump. 'Yes, I did,' Putin said. 'Because he talked about bringing the U.S.-Russia relationship back to normal.' Steele dossier CLAIM: 'They used already discredited information like the Steele dossier — they knew it was discredited at the time.' — Gabbard to Fox News on Tuesday. The dossier refers to a collection of opposition research files compiled by a former British spy, Christopher Steele, whose work was funded by Democrats during the 2016 election. Those files included uncorroborated tips and salacious gossip about Trump's ties to Russia, but the importance to the Russia investigation has sometimes been overstated. It was not the basis for the FBI's decision to open an investigation in July 2016 into potential coordination between the Trump campaign and Russia, the Justice Department's inspector general found. Some of the records released by Gabbard this week also reveal that it was a Central Intelligence Agency human source close to the Kremlin that the agency primarily relied on for its conclusion that Putin wanted to help Trump and hurt Clinton, not the Steele dossier. FBI agents on the case didn't even come to possess the dossier until weeks into their inquiry. Even so, Trump supporters have seized on the unverified innuendo in the document to undercut the broader Russia investigation. Many of Steele's claims have since been discredited or denied. It is true, however, that the FBI and Justice Department relied in part on the Steele dossier to obtain surveillance warrants to eavesdrop on the communications of a former Trump campaign adviser, the inspector general found. FBI agents continued to pursue those warrants even after questions arose about the credibility of Steele's reporting. The dossier was also summarized — over the objections of then-CIA Director John Brennan, he has said — in a two-page annex to the classified version of the intelligence community assessment. Error! Sorry, there was an error processing your request. There was a problem with the recaptcha. Please try again. You may unsubscribe at any time. By signing up, you agree to our terms of use and privacy policy . This site is protected by reCAPTCHA and the Google privacy policy and terms of service apply. Want more of the latest from us? Sign up for more at our newsletter page .
San Francisco Chronicle
an hour ago
- San Francisco Chronicle
Texas AG claimed three homes as primary residence. Democrats are being probed for similar issue
WASHINGTON (AP) — Texas Attorney General Ken Paxton and his wife, Angela, are longtime owners of a $1.5 million house in a gated community outside Dallas. In 2015, they snapped up a second home in Austin. Then another. The problem: Mortgages signed by the Paxtons contained inaccurate statements declaring that each of those three houses was their primary residence, enabling the now-estranged couple to improperly lock in low interest rates, according to an Associated Press review of public records. The lower rates will save the Paxtons tens of thousands of dollars in payments over the life of the loan, legal experts say. The records also revealed that the Paxtons collected an improper homestead tax break on two of those homes at the same time. It is a federal and state crime to knowingly make false statements on mortgage documents. It's also against the law in Texas to collect a homestead tax break on two separate properties. Mortgages have become political fodder The mortgage revelations are sure to become fodder in the Republican primary for a U.S. Senate seat in which Paxton is seeking to topple the incumbent, John Cornyn. The situation is further complicated by the Trump administration's pursuit of Democrats over similar issues. President Donald Trump has accused two of his political foes — Sen. Adam Schiff of California and New York Attorney General Letitia James — of committing mortgage fraud in similar, though far less serious, circumstances. The Democrats have long been targets of Trump's ire for having led various investigations into his conduct as president and as a business executive. The Justice Department has launched a criminal investigation of James. It received a criminal referral for Schiff last week from the Federal Housing Finance Agency. James' attorney, Abbe Lowell, urged the Trump administration to investigate Paxton instead. 'If this administration was genuinely interested in rooting out fraud, it appears they should stop wasting their time on the baseless and discredited allegations against the New York Attorney General James and turn their attention to Texas,' said Lowell, a prominent Washington attorney whose past clients include Hunter Biden and Ivanka Trump. In a statement, Marisol Samayoa, a Schiff spokeswoman, blasted the criminal referral as 'a transparent attempt' by Trump 'to punish a perceived political foe who is committed to holding him to account.' It's unlikely that Paxton, a staunch Trump ally, will face the same federal scrutiny as James and Schiff. It's equally doubtful that Paxton will face much legal trouble in Texas: His office is one of the primary agencies tasked with investigating allegations of mortgage fraud. Ken Paxton and his spokesman did not respond to multiple requests for comment. Angela Paxton, who is a state senator in Texas, did not respond to requests made through her office. Three of the Paxtons' homes are each listed as a primary residence Documents reviewed by the AP show the Paxtons hold mortgages on three homes — one in suburban Dallas, two in Austin — that are each listed as their primary residence. The designation comes with a considerable financial upside. Interest rates on primary homes are significantly lower than those for mortgages on secondary homes or investment properties, saving buyers tens of thousands of dollars — if not more — over the life of a loan. Legal experts say it's possible that the Paxtons' lenders prepared the documents and that the couple did not carefully review them before signing. Even if that were the case, some legal experts say that Paxton, as an attorney and Texas' top law enforcement officer, ought to have known better. 'If he filled out lender documents knowing that they were false, then that is a false statement to obtain a mortgage on favorable terms. That would be actionable,' said Arif Lawji, a veteran Texas real estate attorney. Low interest rates are not the only perk the Paxtons secured, records show. In 2018, they simultaneously collected homestead property tax breaks on their family's home in suburban Dallas, as well as on a $1.1 million home in Austin, property records and tax statements show. A homestead tax break is a property tax reduction that a homeowner is only eligible to collect on one property that is also their primary home. The suburban Dallas home is where the Paxtons' family has long resided. It's where Ken and Angela Paxton are registered to vote. It is located in the state Senate district that Angela Paxton represents in the Legislature, which Ken Paxton held before his election in 2014 to be attorney general. Lawji said the Paxtons' simultaneous collection of two homestead tax breaks appears to be a more clearcut violation. That's because one must obtain a form and submit it to taxing authorities to receive such a tax break, making it an 'intentional act,' he said. The tax break was worth several thousand dollars, a fact that confounded real estate lawyers. 'Why would you try to do all of this,' Lawji said, 'when you are the attorney general? That's a bigger question to me than the money, when you are AG and have to enforce this law.' Schiff and James come under fire from GOP Paxton's real estate dealings are in many ways distinct from those of James and Schiff, the Democrats targeted by the Trump administration. The investigation of James centers on forms she signed in 2023 while helping a niece buy a home. One form stated that James intended to occupy the home as her 'principal residence.' But in other documents, the New York attorney general made clear she had no intention of living there. An email to the mortgage loan broker two weeks before she signed the documents stated the property 'WILL NOT be my primary residence.' For over a decade, Schiff owned homes in Maryland and California, the state he represents, that were both designated as a primary residence. Schiff corrected the issue in 2020 — a step Paxton has not taken. Paxton's real estate dealings are not the first time he has drawn scrutiny for his conduct while in office. He spent roughly 10 years under state indictment on securities charges while serving as the state's top law enforcement official. The charges were eventually dropped in 2024. Other alleged misdeeds led to his impeachment by Texas' GOP-controlled House in 2023. He was acquitted in a trial by the Senate. What ultimately unleashed the impeachment push was Paxton's relationship with Austin real estate developer Nate Paul, who pleaded guilty this year to one count of making a false statement to a financial institution. In 2020, eight top aides in Paxton's office told the FBI they were concerned the state's top law enforcement official was misusing his office to help Paul.
Hamilton Spectator
an hour ago
- Hamilton Spectator
Texas AG claimed three homes as primary residence. Democrats are being probed for similar issue
WASHINGTON (AP) — Texas Attorney General Ken Paxton and his wife, Angela, are longtime owners of a $1.5 million house in a gated community outside Dallas. In 2015, they snapped up a second home in Austin. Then another. The problem: Mortgages signed by the Paxtons contained inaccurate statements declaring that each of those three houses was their primary residence, enabling the now-estranged couple to improperly lock in low interest rates, according to an Associated Press review of public records. The lower rates will save the Paxtons tens of thousands of dollars in payments over the life of the loan, legal experts say. The records also revealed that the Paxtons collected an impermissible homestead tax break on two of those homes, and they have routinely flouted lending agreements on some of their other properties. It is a federal and state crime to knowingly make false statements on mortgage documents. It's also against the law in Texas to collect a homestead tax break on two separate properties. Violating the terms of a mortgage could allow lenders recourse to seek full payment of a loan, according to legal experts. Mortgages have become political fodder The mortgage revelations are likely to become fodder in the Republican primary for a U.S. Senate seat in which Paxton is seeking to topple the incumbent, John Cornyn. The situation is further complicated by the Trump administration's criminal pursuit of Democrats over similar issues. President Donald Trump has accused two of his political foes — Sen. Adam Schiff of California and New York Attorney General Letitia James — of committing mortgage fraud, though legal experts say the circumstances are less serious. The Democrats have long been objects of Trump's ire for having led various investigations into his conduct as president and as a business executive. Paxton, himself, has weighed in on the investigation of James, saying he hoped authorities would look into her conduct. 'I hope that if she's done something wrong, I hope that she's actually held accountable,' he told supporters last month. The Justice Department has launched a criminal investigation of James, FBI director Kash Patel told Fox News in May. The department received a criminal referral for Schiff last week from the Federal Housing Finance Agency, its director William Pulte confirmed in a social media post. Neither the Justice Department nor the FHFA responded to an inquiry about whether they may investigate Paxton, too. James' attorney, Abbe Lowell, urged the Trump administration to investigate Paxton instead. 'If this administration was genuinely interested in rooting out fraud, it appears they should stop wasting their time on the baseless and discredited allegations against the New York Attorney General James and turn their attention to Texas,' said Lowell, a prominent Washington attorney whose past clients include Hunter Biden, Ivanka Trump and Jared Kushner. In a statement, Marisol Samayoa, a Schiff spokeswoman, blasted the criminal referral as 'a transparent attempt' by Trump 'to punish a perceived political foe who is committed to holding him to account.' She added that Schiff disclosed to his lenders that he owned another home that was a principal residence and sought guidance from an attorney. It is unlikely that Paxton, a staunch Trump ally, will face the same federal scrutiny as James and Schiff. It's equally doubtful that Paxton will face much legal trouble in Texas: His office is one of the primary agencies tasked with investigating allegations of mortgage fraud. Ken Paxton and his spokesman did not respond to multiple requests for comment. Angela Paxton, who is a state senator in Texas, did not respond to requests made through her office. Three of the Paxtons' homes are each listed as a primary residence Documents reviewed by the AP show the Paxtons hold mortgages on three homes — one in suburban Dallas, two in Austin — that are each listed as their primary residence. The designation comes with a considerable financial upside. Interest rates on primary homes are significantly lower than those for mortgages on secondary homes or investment properties, saving buyers tens of thousands of dollars — if not more — over the life of a loan. Making a case against Paxton would require 'establishing both that Paxton was aware of the contents of the mortgage document, and also that he was actively aware at the time that he signed it that this was not going to be a primary residence,' said Jennifer E. Laurin, a professor at the University of Texas Law School in Austin. Legal experts say it is possible that the Paxtons' lenders prepared the documents and that the couple did not carefully review them before signing. Even if that were the case, some legal experts say that Paxton, as an attorney and Texas' top law enforcement officer, ought to have known better. 'If he filled out lender documents knowing that they were false, then that is a false statement to obtain a mortgage on favorable terms. That would be actionable,' said Arif Lawji, a veteran Texas real estate attorney. 'He's the chief enforcement officer. You have to be accountable for stuff you do that's wrong.' Paxton collected two 'homestead' tax breaks Low interest rates are not the only perk the Paxtons secured, records show. In 2018, they simultaneously collected homestead property tax breaks on their family's home in suburban Dallas, as well as on a $1.1 million home in Austin, property records and tax statements show. A homestead tax break is a property tax reduction that a homeowner is only eligible to collect on one property that is also their primary home. The suburban Dallas home is where the Paxtons' family has long resided. It's where Ken and Angela Paxton are registered to vote. It is located in the state Senate district that Angela Paxton represents in the Legislature, which Ken Paxton held before his election in 2014 to be attorney general. It's also where Ken Paxton's Senate campaign website until recently said he lived. Lawji said the Paxtons' simultaneous collection of two homestead tax breaks appears to be a more clearcut violation. That is because one must obtain a form and submit it to taxing authorities to receive such a tax break, making it an 'intentional act,' he said. The tax break was worth several thousand dollars, a fact that confounded real estate lawyers. 'Why would you try to do all of this,' Lawji said, 'when you are the attorney general? That's a bigger question to me than the money, when you are AG and have to enforce this law.' Paxton may have violated mortgage terms by renting properties Separately, land records indicate the Paxtons may have violated the terms of at least two mortgages on other houses they own. The mortgage on a home in College Station, Texas, says the property is for the Paxtons' exclusive use and cannot be rented out. Doing so would be grounds for terminating the mortgage, the document states. The home has been listed for rent on real estate websites on-and-off since at least 2022. Ken Paxton also holds a $1.2 million mortgage on a '5 bedroom luxury cabin' in Broken Bow, Oklahoma, that is for rent on Airbnb and other short-term rental sites, records show. The property's mortgage stipulates that it cannot be rented out. Representatives for Stifel Bank, Cornerstone Home Lending and Benchmark Mortgage, which issued the mortgages in question, did not respond to requests for comment. Schiff and James come under fire from GOP Paxton's real estate dealings are in many ways distinct from those of James and Schiff, the Democrats targeted by the Trump administration. The investigation of James centers on forms she signed in 2023 while helping a niece buy a home in Virginia. One form stated that James intended to occupy the home as her 'principal residence.' But in other documents, the New York attorney general made clear she had no intention of living there. An email to the mortgage loan broker two weeks before she signed the documents stated the property 'WILL NOT be my primary residence.' 'As I've said from the beginning, if prosecutors want to know that truth about Attorney General James' mortgage applications, we are ready and waiting with the facts,' said Lowell, James' attorney. For over a decade, Schiff owned homes in Maryland and California, the state he represents, that were both designated as his primary residence. In 2020, then a congressman, Schiff designated his Maryland property as a second home — a step Paxton has not taken. Paxton has faced legal and political challenges Paxton's real estate dealings are not the first time he has drawn scrutiny for his conduct while in office. Before his election as attorney general, Paxton, then a state senator, admitted in 2014 to violating Texas securities law and paid a fine. He spent roughly 10 years under state indictment on securities charges while serving as attorney general. The charges were eventually dropped in 2024. Other alleged misdeeds in office led to his impeachment by Texas' GOP-controlled House in 2023. He was acquitted in a trial by the Senate. Angela Paxton did not cast a vote in his impeachment trial and recently filed for divorce, citing Ken Paxton's infidelity and other 'recent discoveries.' She did not elaborate. What ultimately unleashed the impeachment push was Paxton's relationship with Austin real estate developer Nate Paul, who pleaded guilty this year to one count of making a false statement to a financial institution. In 2020, eight top aides in Paxton's office told the FBI they were concerned the state's top law enforcement official was misusing his office to help Paul over the developer's unproven claims about an elaborate conspiracy to steal $200 million of his properties. The House impeachment managers accused Paxton of attempting to interfere in foreclosure lawsuits and issuing legal opinions to benefit Paul. They also alleged that Paul employed a woman with whom Paxton had an affair in exchange for legal help and that the developer paid for expensive renovations to the attorney general's home in Austin. That would be the same house that he declared in mortgage documents was his third primary residence. Error! Sorry, there was an error processing your request. There was a problem with the recaptcha. Please try again. You may unsubscribe at any time. By signing up, you agree to our terms of use and privacy policy . This site is protected by reCAPTCHA and the Google privacy policy and terms of service apply. Want more of the latest from us? Sign up for more at our newsletter page .
