For The People: Medicaid Expansion
March 31, 2021
Elaine Phaneuf
In August, the people of Missouri voted for Medicaid expansion. Last week, Republican legislators initiated an attempt to overthrow the expansion citizens had voted for.
Governor Parsons allocated the necessary funds to make the expansion happen in his state budget proposal. The money was set aside; the House Budget Committee Chairman took it out. No funding equals no expansion.
The reasoning for stopping the funding for expansion was the conservative prediction that Missouri’s share of the cost could increase over time and cause financial disaster for the state.
The state reps in the budget committee who blocked the funding for expansion say that a single, able-bodied person can work full-time at a minimum wage job and cover all their own expenses including health care. They shouldn’t need state assistance. Instead, the money intended for expansion should be reallocated to help the most vulnerable, the elderly. They claim Missouri’s Medicaid program - Mo HealthNet - can barely cover who it covers now: the disabled, the elderly, children, and pregnant women. Previously in the public debate over expansion, one Republican official even declared that now - during a pandemic - is not the time to expand Medicaid.
The conservative prediction that expansion will cause financial disaster for the state has been countered with evidence showing that just the opposite will result from expansion. Financial studies and statistics from states already taking advantage of Medicaid expansion indicate the influx of federal funding and a careful plan will bolster struggling rural hospitals in Missouri, reduce medical debt and bankruptcies, provide more healthcare jobs, reduce disease related deaths, reduce avoidable emergency medical treatment, reduce job insecurity for folks with untreated health issues, and even create a budget savings - making more funds available for other priorities such as education and infrastructure.
Almost every healthcare organization in Missouri is in support of Medicaid expansion. A spokesperson for Cox regional hospitals in SW Missouri expressed confidence that expansion will happen because the people voted for it and it is part of our constitution.
“ . . . we know that expanding Medicaid will bring federal tax dollars back to our state that will be more than sufficient to pay for the program. Most importantly, this program will save lives,” Cox representatives said in a recent statement.
Last week, I wrote about the hearings for House Bills 557 & 560 where individuals gave testimony of abuse they endured in unregulated reform schools in Missouri. Physical, emotional, and mental pain will be with them for the rest of their lives. What are their options in Missouri without Medicaid expansion? The process of obtaining disability status is notoriously difficult, arduous and lengthy - taking as long as years. Maybe the stigma of a disability label isn’t what they need.
People with mental/emotional health issues are often left at the fringes of society and sometimes - inappropriately - end up in jail. Maybe what they need is to be able to work part-time for one of the many employers who do not offer health insurance, or the ability to work odd jobs, or run a small home business. That way they can still have the dignity of contributing to society, paying for their own needs, AND getting the mental and physical health care they so desperately need through enrollment in Medicaid without the stigma of a disability. As it is, so many struggle daily knowing help is there but is out of reach because they do not have the funds to pay for it.
Missouri’s constitution demands a balanced budget, but the hundreds of thousands of Missourians living between 20 percent and 133 percent of the federal poverty level do not have the luxury of a balanced budget. They live paycheck to paycheck and every unexpected expense like an emergency room bill - for something like a busted eardrum - adds to their growing debt. That E.R. visit could have been avoided if they had coverage for a doctor visit to stop the infection before it became an emergency.
The least we can do is take care of all of Missouri’s most vulnerable by expanding Medicaid. And maybe we can do more. Maybe we can show respect and compassion for those who struggle every day with mental/emotional health issues and those who never have enough to balance their own budget.
The Chairman of the house budget committee was given kudos for blocking the expansion funding. He was praised by fellow conservatives for his commitment to fiscal responsibility and a balanced budget.
Low-income Missourians probably will not be celebrating Missouri’s balanced budget if Medicaid expansion is not included. They will be discouraged - but maybe not surprised - knowing nothing will change for them, knowing the majority of the legislators are fighting to keep them from getting the care their fellow Missourians said they should have.
Elaine Phaneuf
In August, the people of Missouri voted for Medicaid expansion. Last week, Republican legislators initiated an attempt to overthrow the expansion citizens had voted for.
Governor Parsons allocated the necessary funds to make the expansion happen in his state budget proposal. The money was set aside; the House Budget Committee Chairman took it out. No funding equals no expansion.
The reasoning for stopping the funding for expansion was the conservative prediction that Missouri’s share of the cost could increase over time and cause financial disaster for the state.
The state reps in the budget committee who blocked the funding for expansion say that a single, able-bodied person can work full-time at a minimum wage job and cover all their own expenses including health care. They shouldn’t need state assistance. Instead, the money intended for expansion should be reallocated to help the most vulnerable, the elderly. They claim Missouri’s Medicaid program - Mo HealthNet - can barely cover who it covers now: the disabled, the elderly, children, and pregnant women. Previously in the public debate over expansion, one Republican official even declared that now - during a pandemic - is not the time to expand Medicaid.
The conservative prediction that expansion will cause financial disaster for the state has been countered with evidence showing that just the opposite will result from expansion. Financial studies and statistics from states already taking advantage of Medicaid expansion indicate the influx of federal funding and a careful plan will bolster struggling rural hospitals in Missouri, reduce medical debt and bankruptcies, provide more healthcare jobs, reduce disease related deaths, reduce avoidable emergency medical treatment, reduce job insecurity for folks with untreated health issues, and even create a budget savings - making more funds available for other priorities such as education and infrastructure.
Almost every healthcare organization in Missouri is in support of Medicaid expansion. A spokesperson for Cox regional hospitals in SW Missouri expressed confidence that expansion will happen because the people voted for it and it is part of our constitution.
“ . . . we know that expanding Medicaid will bring federal tax dollars back to our state that will be more than sufficient to pay for the program. Most importantly, this program will save lives,” Cox representatives said in a recent statement.
Last week, I wrote about the hearings for House Bills 557 & 560 where individuals gave testimony of abuse they endured in unregulated reform schools in Missouri. Physical, emotional, and mental pain will be with them for the rest of their lives. What are their options in Missouri without Medicaid expansion? The process of obtaining disability status is notoriously difficult, arduous and lengthy - taking as long as years. Maybe the stigma of a disability label isn’t what they need.
People with mental/emotional health issues are often left at the fringes of society and sometimes - inappropriately - end up in jail. Maybe what they need is to be able to work part-time for one of the many employers who do not offer health insurance, or the ability to work odd jobs, or run a small home business. That way they can still have the dignity of contributing to society, paying for their own needs, AND getting the mental and physical health care they so desperately need through enrollment in Medicaid without the stigma of a disability. As it is, so many struggle daily knowing help is there but is out of reach because they do not have the funds to pay for it.
Missouri’s constitution demands a balanced budget, but the hundreds of thousands of Missourians living between 20 percent and 133 percent of the federal poverty level do not have the luxury of a balanced budget. They live paycheck to paycheck and every unexpected expense like an emergency room bill - for something like a busted eardrum - adds to their growing debt. That E.R. visit could have been avoided if they had coverage for a doctor visit to stop the infection before it became an emergency.
The least we can do is take care of all of Missouri’s most vulnerable by expanding Medicaid. And maybe we can do more. Maybe we can show respect and compassion for those who struggle every day with mental/emotional health issues and those who never have enough to balance their own budget.
The Chairman of the house budget committee was given kudos for blocking the expansion funding. He was praised by fellow conservatives for his commitment to fiscal responsibility and a balanced budget.
Low-income Missourians probably will not be celebrating Missouri’s balanced budget if Medicaid expansion is not included. They will be discouraged - but maybe not surprised - knowing nothing will change for them, knowing the majority of the legislators are fighting to keep them from getting the care their fellow Missourians said they should have.
