Missouri's Medicaid program is set to drop chiropractic care and several other complementary, non-opioid pain treatments for many recipients on July 1, 2026, after lawmakers quietly pulled funding in the state's fiscal-year 2027 budget. Providers warn the move could push patients away from routine, lower-cost care and toward pricier, less accessible options.
The cut slipped into the FY27 spending plan when Rep. Darin Chappell introduced an amendment that stripped $658,660 from MO HealthNet line items, effectively ending Medicaid coverage of chiropractic services and certain physical-therapy and acupuncture benefits, according to Missouri Independent. Chappell chairs the House appropriations subcommittee that oversees health and social-services spending, according to his biography on the Missouri House of Representatives website.
Chiropractic groups say they never saw it coming. "I did not know about the cut until the Independent reached out," Missouri Chiropractic Physicians Association executive director Derek Leffert told Missouri Independent. The association says it was not consulted before the budget change, and it lists Leffert as executive director on its website, the Missouri Chiropractic Physicians Association.
How The Benefit Started
MO HealthNet first added chiropractic therapy, physical therapy and acupuncture to a complementary-care program for chronic pain on April 1, 2019, as part of a broader state effort to expand non-opioid treatment options and curb reliance on prescription opioids, according to a 2019 release from the Department of Social Services. Department guidance and provider manuals spelled out medical-necessity criteria and visit limits for chiropractic services.
The Budget Argument
When lawmakers opened up Medicaid reimbursement to chiropractors in 2018, legislative fiscal staff and the Department of Social Services modeled a range of potential costs and savings, banking on the idea that better access to non-opioid care could reduce opioid prescribing and cut down on hospital or surgical interventions. A 2018 oversight analysis from the Missouri Senate laid out several multi-million-dollar scenarios, depending on how heavily patients used the benefit and how the assumptions played out.
Who Stands To Lose Care
Roughly 1.26 million Missourians were enrolled in MO HealthNet in April 2026, according to the state's caseload counter, so any tweak to covered services hits a wide swath of the safety net. Research on complementary pain-care programs suggests that when lower-cost outpatient options are removed, care can shift toward emergency departments and more invasive procedures, driving up overall costs and worsening access for people living with chronic pain, according to a review published on PubMed Central.
What Comes Next
The chiropractic and complementary-care cut is scheduled to take effect July 1, 2026. Between now and then, providers and patient advocates say they plan to press lawmakers and the Department of Social Services for clarity and potential fixes when the next legislative session rolls around. For now, MO HealthNet continues to post benefit tables and provider resources on its website for enrollees trying to figure out what will still be covered and what alternatives they might have.
