Hello LeadingAge Missouri Members!  If we are channeling Rogers & Hammerstein, “June is Bustin’ Out All Over.” But Megan Thee Stallion’s rap song, “Budget,” best describes my perspective this June.  Three budgets are important to LA MO members right now.

LeadingAge Missouri

Your association’s Annual Conference concluded last Friday.  Highlights included: An inspirational keynote delivered by Presidential Medal of Freedom recipient and Homeboy Industries founder, Father Greg Boyle Instructive education sessions on timely topics (recordings available soon!) Interactive advocacy development and Member recognition.

At our “Ripples of Impact” Conference, we awarded 17 “Impact Awards” to worthy members and we bestowed the E. Willis Piehl Award of Honor to Dan Rexroth, retiring John Knox Village CEO.  It was great being with so many of you for fellowship and fun!  By any measure, the Conference was a success!  Thanks to all who attended and to the generous Sponsors and Exhibitors who made it possible!  Save the date and join us next year, May 18-20!

So, why is the Annual Conference a budget issue?  Well, it gave LA MO a late budget boost.  Unlike FY 2024, we are optimistic we will deliver positive net income for FY 2025 ending this month.  FY 2024 results will be shared at a virtual Annual Business Meeting this fall – with free education offered!  Currently, LA MO is budgeting for a positive and productive FY 2026 based on 2025 member gains and improved non-dues revenue.  We ask members to support your association’s growth and financial stability by referring member prospects to us, sharing your non-dues revenue ideas, and participating in all that LA MO offers. 

State of Missouri

Sent to the Governor May 9, the Missouri Budget awaits his approval or line-item vetoes.  As shared in prior communications, Missouri’s Budget does not contain Medicaid rate increases for SNFs or HCBS in FY 2026 (commencing July 1, 2025), but importantly, it appropriates money for higher SNF and HCBS utilization in 2026 at 2025 rates.  We expect the Governor to approve the Medicaid spending because it is consistent with his budget recommendations.  As indicated below, however, there are budget storm clouds on the horizon in Missouri.  

Congressional Budget Reconciliation

On May 22, the House of Representatives passed a Budget Reconciliation bill advancing much of President Trump’s domestic policy agenda.  The “One Big Beautiful Bill” (“OBBB”), as the reconciliation bill is called, now moves to the Senate where aging services providers will advocate for changes.  LA MO is working with LeadingAge to lobby both of Missouri’s Senators about the OBBB’s Medicaid and Medicare cuts.

If the OBBB becomes law, more than 10 million people will lose health care coverage – approximately 8 million from Medicaid reforms and 2 million from new Marketplace restrictions.  While LeadingAge applauds the bill’s moratorium on CMS’ SNF staffing mandates and positive provisions that bolster affordable housing, LeadingAge remains strongly opposed to Medicaid and Medicare cuts the OBBB will trigger.  

Members are invited to review LeadingAge’s summary of OBBB’s healthcare changes here. The biggest changes to Medicaid are mandatory work requirements, additional cost-sharing and more frequent eligibility reviews for individuals qualified under MO’s Medicaid expansion, restrictions on retroactive coverage, limitations on provider taxes, restrictions on coverage for legal immigrants, and a rollback of Medicaid eligibility and enrollment regulations.  Of these, LA MO Members should be especially concerned about changes to provider tax limits, eligibility reviews & restrictions, and shorter retroactive coverage.  

While coverage for member residents dependent on Medicaid long term care benefits is not specifically targeted (indeed, our residents will typically be exempt from work requirements), the cumulative effect of the Medicaid changes will cost MO HealthNet hundreds of millions of dollars in traditional reimbursements.  Missouri is constitutionally obligated to provide healthcare benefits to its expanded Medicaid population.  Accordingly, the Missouri Legislature could be forced to make tough Medicaid coverage and eligibility choices to plug a large State Medicaid budget hole.  It’s unrealistic to think Missouri won’t consider HCBS and SNF Provider rate cuts, or ending optional HCBS altogether, to balance its State Budget.  

Missourians deserve better!  Help us stop devastating Medicaid cuts in the OBBB!  Members can support LA MO and LeadingAge advocacy by communicating with Senators Hawley and Schmidt through this link.

Yours in service,