06/30/2026
TLDR: This was the response I received to my letter asking the Governor to reconsider his parties position on removing coverage for chiropractic, acupuncture, and physical therapy services for Medicaid recipients.
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Beginning tomorrow, Missouri Medicaid beneficiaries will lose coverage for chiropractic care, acupuncture, and physical therapy—essential healthcare services that many individuals rely on to manage pain, recover from injuries, avoid surgery, and maintain their quality of life. Read the letter below.
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Governor Kehoe,
I am writing as a Missouri chiropractor and small business owner who treats Medicaid patients every week. I am asking you to reconsider the decision to eliminate Medicaid coverage for chiropractic, physical therapy, and acupuncture.
This decision will not simply reduce access to care. It will remove conservative treatment options that thousands of Missourians rely on to function, work, care for their families, and avoid more invasive medical interventions.
I have read Representative Darin Chappell's statement that approximately 2,000 Medicaid beneficiaries used these services each year. Frankly, I struggle to reconcile that number with what I have personally seen in practice. If that figure is accurate, my office alone would represent an astonishing percentage of the state's entire utilization. That simply does not reflect the reality I have experienced caring for Missouri patients. If this number is driving policy decisions, I believe it deserves a thorough review before healthcare access is taken away from vulnerable people.
Many patients pursuing orthopedic surgery are required to complete conservative care before surgery is approved. Physical therapy and chiropractic care are frequently part of that process. Conservative care also plays an important role after surgery, helping patients recover mobility, reduce pain, and improve outcomes. Eliminating these services does not eliminate the need for treatment. It simply removes effective, lower-cost options and leaves patients with fewer choices.
Missouri, like the rest of the country, has spent years trying to reduce unnecessary opioid use and avoid surgeries whenever possible. Chiropractic care, physical therapy, and acupuncture are exactly the types of conservative treatments that help patients manage pain without relying on narcotics. Removing coverage sends patients in the opposite direction—toward more medication, more emergency room visits, and potentially more surgeries that might have been delayed or avoided altogether.
As a Republican governor supporting the Make America Healthy Again movement championed by President Trump, this decision appears inconsistent with those goals. MAHA emphasizes prevention, addressing root causes, reducing dependence on pharmaceuticals, and expanding access to healthier approaches to chronic disease and pain management. Eliminating coverage for three of the state's primary conservative treatment options moves Missouri away from those principles, not toward them.
The amount removed from the budget is relatively small compared to the potential downstream costs of increased imaging, medications, injections, surgeries, disability, and lost productivity. Cutting preventive care rarely saves money in the long term. It simply shifts costs elsewhere.
I ask that you work with legislators, providers, and patients to restore coverage for chiropractic care, physical therapy, and acupuncture under MO HealthNet. Missouri's Medicaid patients deserve access to conservative care that keeps them healthy, working, and out of operating rooms whenever possible.
Respectfully,
Dr. Alika McGuire, DC
McGuire Total Wellness
St. Louis, Missouri
