A day after Missouri voters approved an expansion of the Medicaid health care program, Republican Gov. Mike Parson said the state will prepare for its implementation.

"The people of the state of Missouri voted that in, so we're going to have to deal with it and implement it," he told media Wednesday during his weekly briefing in Jefferson City. "That was the will of the voters."

Voters in Missouri on Tuesday approved a constitutional amendment that expands Medicaid to approximately 230,000 low-income adults in the state. The measure was largely supported by the state's urban areas and garnered a little more than 53% of the statewide vote, although voters in Jasper and Newton counties and many rural areas heavily rejected it.

The ballot initiative was initially slated for the November election, but Parson, who was opposed to Medicaid expansion, moved it to the Aug. 4 primary. He said at the time that if the measure passed, the state would need time to prepare its budget and find funding sources for the expansion.

Parson, who has previously said that an expansion of Medicaid could mean cuts to other government services, on Wednesday said he hopes to have a clearer picture of the state's finances by the end of the calendar year. Revenues have taken a hit from the coronavirus pandemic, and estimates have suggested that Medicaid expansion could cost the state as much as $200 million or save as much as $1 billion annually by 2026.

"We'll just have to find the money to pay for it, and we'll figure that out," Parson said. "Hopefully, the economy gets better and we can meet that financial obligation a little easier."

Meanwhile, Parson's opponent in the November gubernatorial race, Democrat Nicole Galloway, said she's the best candidate to enact Medicaid expansion.

“We can expand health care without raising taxes or cutting other programs,” Galloway, the state auditor, said in a speech after winning the Democratic nomination on Tuesday. “As governor, that’s exactly what I’ll do. Gov. Parson won't, so it matters who is sitting in the governor's office next year when it comes time to implement Medicaid expansion."

Expanded eligibility under the program is to be in effect by July 1, 2021.

In Kansas

With Medicaid expansion having been adopted in Missouri, many have now turned to neighboring Kansas.

Democratic Gov. Laura Kelly, who has made Medicaid expansion her No. 1 priority in 2020, in a statement on Wednesday urged the Republican-led state Legislature to follow nearby Missouri, Oklahoma, Colorado and Nebraska to pursue its own expansion of the health care program.

"Every single Kansas voter must ask themselves why, year after year, Republican leadership in the Legislature has blocked expansion," she said in her statement. "Their obstruction has left 150,000 Kansans without access to health care during a global health crisis. They have forfeited $4 billion Kansas taxpayer dollars. They have rejected 13,000 new jobs that we could bring to Kansas. Republican leadership in the Legislature must stop playing politics with Kansans' lives and support Medicaid expansion."

In Kansas, past Republican governors’ staunch opposition to such proposals, centered mainly on the cost of implementation, has thwarted expansion efforts despite bipartisan legislative majorities favoring it before Kelly took office early in 2019. Medicaid expansion passed in the Kansas Legislature in 2017, but was vetoed by Republican Gov. Sam Brownback, according to the Kaiser Family Foundation.

In January, Kelly and Jim Denning, the Republican state Senate majority leader, together drafted a plan to expand Medicaid, but that plan failed to gain traction before the 2020 legislative session ended. It was blocked in large part by state Senate President Susan Wagle, who contended that expansion would lead to an increase in taxpayer-funded abortions.

The Associated Press contributed to this report.

Emily Younker is the managing editor at the Joplin Globe. Contact: eyounker AT joplinglobe DOT com.