Congressional Medicaid Cuts and Work Requirements Could Threaten Coverage in Missouri and Kansas

Recent proposals in Congress aim to cut Medicaid funding and implement work requirements for eligibility, potentially affecting millions of Americans. The Congressional Budget Office (CBO) estimates that these changes, alongside proposed Affordable Care Act modifications, could lead to 16 million people losing health insurance coverage by 2034.

Rural states like Missouri and Kansas, which rely heavily on Medicaid and SNAP benefits, are predicted to be disproportionately impacted. For example, Missouri could see approximately 210,000 people lose coverage, despite having expanded Medicaid through a constitutional amendment. Work requirements would mandate adults aged 19-64 to work or engage in community service or education for at least 80 hours monthly, with some exemptions. However, increased administrative eligibility checks may result in coverage loss due to bureaucratic complexities rather than non-compliance. The legislation also limits federal funding avenues for states, forcing budget adjustments such as lowering Medicaid reimbursement rates, which could further strain already fragile rural healthcare systems.

Hospital closures are a significant concern, with 28% of Kansas hospitals and 17% in Missouri facing potential shutdowns. This threatens access to essential services like maternity care. SNAP benefits are also at risk, with expanded work requirements potentially causing millions to lose food assistance, including elderly and disabled individuals. The rural economy could be adversely affected as local retailers dependent on SNAP spending might experience declines in revenue, negatively impacting community employment and growth. These proposed policy shifts underscore the complex challenges facing Medicaid and social assistance programs amid budget constraints and administrative reforms.