Medicaid Saves Lives.
Why Won’t Republicans
Expand It?
By Charlotte Kramon, Staff Writer
Will Republicans ever stop using false claims about fiscal responsibility as excuses for dismissing the wellbeing and desires of their own constituents?
At this point, the answer seems to be no.
Amendment 2, which would add Medicaid expansion into Missouri’s state constitution, passed in August with 53% of the vote. Expansion would insure 270,000 Missourians, ⅔ of whom are currently uninsured and ⅓ of whom cannot afford to pay for their private plans. On the economic side, Washington University projected that expansion would increase economic output by $2.5 billion and create 16,000 new jobs. Despite the constituents’ overwhelming approval of the amendment and abundantly clear benefits, Missouri Republicans are refusing to include expansion in the state budget.
The current state of healthcare access in Missouri is dismal. Dozens of rural hospitals have closed or are in danger of closing, meaning that people in rural communities sometimes have to drive hours to find care even in emergency medical scares. View over here to find the nearest walk-in clinic east gunhill rd that is present in and around your neighborhood. Additionally, the cutoff for Medicaid qualification is one of the lowest in the country. Parents with dependent children that make more income than 22% of the poverty level are not eligible for Medicaid. This amounts to less than $3832.40 per year for a family of two, and an average of $10,000 to $12,000 for larger families. To put this in perspective, some of these families have incomes that are about 15% of Washington University’s tuition, but they have to pay for food, clothes, housing, cars, etc. and still do not qualify for Medicaid. Regardless of how sick they are, these people cannot afford an emergency room bill for hundreds of dollars, let alone a visit to the doctor, without destroying their family’s financial stability or being a burden to their loved ones.
Some low-income individuals do end up at hospitals, and the timely administrative procedures for patients without healthcare delay emergency care. Countless calls are exchanged as receptionists and physician assistants try to navigate uncoordinated bureaucracies and figure out how to fund costly but life-saving procedures. In these life-or-death situations, time is precious.
All of these problems were alleviated when other states expanded Medicaid. Rural hospital closures dropped, administrative burdens were assuaged, and more people used healthcare services. The Affordable Care Act (ACA) initially required states to expand Medicaid. Because of the ACA, the federal government would cover 90% of the costs if Missouri were to expand Medicaid. However, a 2012 federal lawsuit made expansion optional. As a result, despite the successes in neighboring states, Missouri is one of 13 states that have not expanded Medicaid.
Not only would federal funds cover the majority of the costs, but Medicaid expansion would actually save Missouri $1 billion annually. In the long-run, it is cheaper to expand Medicaid than to continue the program using state funds. Still, Republicans are so opposed to expansion that they even disregarded Republican Governor Mike Parsons’ order to include Medicaid expansion in the state budget. First, they tried to compromise by proposing a bill to the state Senate Appropriations Committee. The bill was supposed to reach a compromise by including $60 million for Medicaid expansion instead of Parsons’ requested $120 million. The House passed a plan that included no funding for Medicaid expansion. In both cases, members of Congress claim that funding should go towards school transportation, public defenders, nursing homes, and disability services, relying on the misguided notion that Medicaid funding and funding for other programs like disability services are mutually exclusive. In reality, this is not the case: in fact, many studies have indicated the opposite. By saving $1 billion, Medicaid expansion would free up money for other programs. Representatives also seem to be forgetting the funding Missouri would receive from the American Rescue Plan. “Under the Rescue Plan, newly expanding states will receive a 5-percentage-point increase in their federal medical assistance percentage (or FMAP) for all non-expansion enrollees, who account for most of a state’s Medicaid enrollees and costs. For Missouri, this would mean more than $1 billion in additional federal funds over two years, we and others estimate,” Jesse Cross-Call from the Center on Budget and Policy Priorities writes.
Institutional racism is another likely cause for resistance to Amendment 2. Black and other minority communities make up a disproportionate number of uninsured people and also make up the majority of Missouri’s low-income population. Despite their low-income status, these communities are systematically excluded from healthcare coverage. These groups would benefit from the state’s ability to save and redirect money towards other poverty-reducing initiatives such as education improvement.
We know that Medicaid expansion would generate billions of dollars for the economy. Republicans claim that the initiative is expensive or that the Medicaid program itself is dysfunctional and thus should not receive funding, but this argument is backwards; the program is struggling because it is underfunded. Perhaps, then, they are resistant to expansion because their mentality is zero-sum. A policy that primarily helps low-income people of color, they think, will damage their own wallets.
Regardless of their reasoning, voters overwhelmingly approved Amendment 2. Legislators’ disregard for their wishes is a gross abuse of power and undermines democratic norms. Even more gross is their willingness to keep hundreds of thousands of lives at risk. When lives are on the line, fiscal responsibility is no longer a credible argument, especially when claims about fiscal responsibility are false.