Catching a Monkey

In parts of Asia and Africa, there is a clever way to trap monkeys using nothing more than a jug, a rope, and a shiny object. A jug, whose opening should be just wide enough for a monkey’s arm to reach inside, is tied to a tree, and a shiny object is placed inside. Eventually, a curious monkey comes along, sees the object in the jug, and reaches in. However, with its fist now wrapped around the prize, it can’t pull its arm out. Even as danger approaches, the monkey won’t let go. Greed overrides fear, and the monkey is trapped by its own foolish stubbornness.

In a similar way, Missouri Republicans are trapped by their own rigid ideology.

When the Affordable Care Act passed in 2010, it offered states an incredibly generous deal: the federal government would cover 90% of the cost to expand Medicaid to low-income adults in the state. Missouri’s Democratic governor at the time urged the Republican-controlled legislature to adopt the expansion through statute. In other words, pass a law to implement Medicaid expansion. This would have allowed the state to accept billions in federal dollars while preserving the flexibility to modify or repeal the program later if circumstances changed.

But Missouri Republicans wouldn’t budge. Their opposition wasn’t rooted in economics; it was rooted in stubborn politics. They refused to support anything associated with “Obamacare,” even if it meant turning down life-saving care for hundreds of thousands of Missourians. For nearly a decade, they blocked every attempt to enact expansion through normal legislative channels, condemning their constituents to suffer unnecessarily from disease, mental illness, substance abuse, and other preventable maladies.

So, in 2020, Missouri voters had had enough and took matters into their own hands. They used the state’s initiative petition process to bypass the legislature and write Medicaid expansion directly into the Missouri Constitution. That move changed everything.

Unlike a statute, which lawmakers can revise or repeal during any legislative session, a constitutional amendment requires another statewide vote to alter or remove. With roughly 20% of Missouri’s population dependent on Medicaid, that’s not likely to happen. It’s an entirely different level of permanence. It’s a shiny-object trap that Missouri Republicans unwittingly set for themselves. Had they simply passed a statute in the early 2010s, they could have retained control and flexibility over the program. But by refusing to act and stubbornly clinging to their shiny object ideology, they left voters with no choice but to force their hand. The voters indeed forced their hand, and they did so permanently.

This goes beyond poetic justice. It’s a real policy problem for Republicans today.

If the federal government ever reduces its 90% subsidy, Missouri will still be constitutionally obligated to fund Medicaid at current levels. No statute can override the Constitution. Without the ability to scale back, the state would face a fiscal crisis. Budget cuts or tax increases may be the only remaining options. Republicans have already cut budgets to the bone, so they’re going to have to increase taxes or watch helplessly as the state declares bankruptcy. Either scenario leaves Republicans in a terrible position.

It’s very likely that the federal subsidy will be cut. Powerful interests at the federal level, including billionaires like Elon Musk and his army of teenage pimple-faced DOGE hacks, are already circling like vultures over Medicaid, hungry for privatization and tax windfalls, and Republicans at the federal level lack the backbone to stand up for the people. They’d rather let Republicans at the state level take the fall.

Like the monkey who just couldn’t let go, Missouri Republicans now find themselves trapped by their refusal to accept reality when they had the chance. And the shiny object they grabbed? It wasn’t even a prize. It was just the illusion of control.