Data shows nearly 90,000 children and close to 23,000 adults were dropped from Missouri’s Medicaid health care program in the past year, prompting a state Democratic leader to call for an investigation.

House Minority Leader Crystal Quade on Sunday publicly released a letter she wrote to Republican House Speaker Elijah Haahr days earlier asking him to launch an investigation of the recent enrollment drop.

“As parents, you and I can both appreciate how wrenching it must be for a mother or father to know their child needs medical attention and to learn they may not be able to get the care they need,” Quade wrote to Haahr, who has four children.

In an interview with The Associated Press on Monday, Quade cited concerns about unexpected medical bills that could force people to choose between paying a bill that should be covered by Medicaid or taking a hit to their credit.

She also warned about the implications for parents trying to vaccinate their children before school but suddenly finding that they’re no longer covered.

Haahr did not immediately comment Monday.

Medicaid is a federal government program that, in Missouri, provides health insurance for children, pregnant women, people with disabilities and other vulnerable, low-income communities.

Quade wrote that the drop doesn’t appear to be caused by an improving economy. If that were the case, Quade said Missouri would have also seen a similar decline in the number of people receiving food stamps and other government aid.

Department of Social Services spokeswoman Rebecca Woelfel in a Monday email said the agency received a copy of Quade’s letter earlier that day and “will be updating the responses we have provided to lawmakers and others in the past regarding enrollment changes.”

Lobbyist spending on lawmakers drops 94 percent after cap

Lobbyist spending on Missouri lawmakers has dropped by 94 percent since voters approved a $5 cap on gifts last year.

A KCUR analysis of state data concludes that lobbyists spent less than $17,000 on lawmakers in this year’s legislative session compared with last year’s spending of about $300,000.

“These sorts of financial gifts or benefits that have been directed to lawmakers don’t actually buy their votes, but they do buy access,” said Peverill Squire, a political science professor at University of Missouri. “That access is important because lawmakers have to decide how they are going to spend their time and what energy they want to devote to different topics.”

More than 60 percent of voters supported the change in November.

Now, according to Squire, most of the spending is on larger events that all lawmakers can attend. There is still a $5 limit per lawmaker for those events.

Kelly Gillespie, lobbyist and president of the Missouri Biotech Association, said his group last year spent about $4,000 on a tour of life science businesses in western Missouri in an effort to educate lawmakers on drug discovery and health care affordability. That amount is prohibited under the new rules.

“I believe that the state is worse off by not having an education program like that where there is absolutely no direct ask of these legislatures other than, ‘Can you make Missouri better?’” Gillespie said.

But he said he understands why voters supported the change to spending protocols.

“There were other folks that were taking people to the Daytona 500 or to rock concerts or Masters golf tickets,” Gillespie said. “And there was a feeling that it had gotten too much, and it was the Wild West.”

Sean Soendker Nicholson, campaign director at the organization Clean Missouri, said lobbyist spending was a bipartisan issue.

“Voters left, right and center were all disgusted at the problem that was in Jefferson City,” he said.