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Expanding Medicaid makes economic sense


To the Editor:

While I agree expanding Medicaid has moral obligations, which are, looking out for the common good – by providing health care for 300,000 of Missouri’s working poor and saving 700 lives who die each year without health insurance – all too often we fail to forget Missouri’s economy will be enhanced.

Missouri is the “Show Me” state. So I’ll show you.

Thirty states, that have already expanded Medicaid, are saving state funds by moving people that are currently eligible for state-funded programs to the federally-funded expansion. As they draw down billions of federal dollars to help cover the uninsured and provide health security to working families, they reduce their own spending, resulting in net fiscal gains. Missouri is already expected to save at least $100 million annually when Medicaid expansion is fully implemented.

This added financial boost will increase those net savings in the initial years. Specifically, $2.3 billion dollars could be injected into Missouri’s economy; 24,000 jobs would be retained and created in the first year, according to the Missouri Budget Project. These 24,000 jobs provide needed income tax revenue for the state. Beyond the fiscal benefits to the state, closing the coverage gap will allow people without health insurance to remain in their jobs or get back to work. Again, income tax revenue for the state.

These Missourians are in “the gap” making too much to be covered by Medicaid and not earning enough to be covered by the subsidies of the Affordable Care Act. People who are trying to work and trying to meet their health insurance requirements are caught in a political game being played by the Missouri Legislature. It’s time this legislature took full advantage of the federal governments offerings in reducing the cost of health care in Missouri and in meeting the needs of the Missouri citizens caught in this gap.

Kentucky opted to expand Medicaid in 2013 and has enrolled 425,000 citizens in the program. A study concluded that expansion will, through 2021, add $30 billion to the state’s economy with 40,000 jobs. It turns out that encouraging regular doctor visits with Medicaid coverage actually prevents expensive and less profitable emergency room procedures, bringing down costs of medical care for all of us and lowering premiums.

Hospitals that treat uninsured folks at the ER rely on federal reimbursement programs for uncompensated care, but even that funding is going away as Medicaid becomes the standard answer across the country for the otherwise uninsured. Our rural hospitals in particular are struggling because so much of their clientele is low income and uninsured. Many of those people would qualify for Medicaid if it were expanded in Missouri. The cost, one way or another, gets passed along to those with insurance.

So while other states are adding jobs and keeping people healthy, Missouri ranked 36th for 2015 among states in overall health, according to americashealthrankings.org. Business Insider recently ranked Missouri’s economy 47th among states in economic growth. Mercy Health Systems trimmed several hundred positions in 2015, and many rural hospitals are barely able to keep the lights on. Two have closed, and another is on the brink.

We could be saving lives and saving dollars, but instead, what most of our legislators seem to be interested in saving is political face.

Until we elect leaders who will act responsibly in the face of facts, even if the facts differ from their own agendas, we will continue to be challenged by misinformation and costly partisan ambition while our state falls further behind our neighbors. Insurance premiums will continue to climb, hospitals will struggle financially and thousands of Missourians will suffer needlessly.

Expanding Medicaid will energize Missouri’s economy.

Ed Shew

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