Momentum is gathering for a push to get Medicaid expansion in Missouri on a ballot for 2020.
Jefferson City Area Indivisible will host a panel discussion about the issue Nov. 12 at Missouri River Regional Library, 214 Adams St.
The discussion, from 7-8:30 p.m. in the library art gallery, will feature three panelists: Mary Becker, a senior vice president for the Missouri Hospital Association; Katie Reichard, director of governmental affairs for Missouri Primary Care Association; and Connie Mihalevich, an MU Health Care employee who is knowledgeable about Medicaid eligibility.
Mary Schantz, chair of event planning for JCA Indivisible, said the panel is intended to be an unbiased group that will look at the benefits and challenges associated with Medicaid expansion.
The Affordable Care Act directed all states and the District of Columbia to expand their Medicaid programs to cover all adults with incomes up to 138 percent of the federal poverty level. A subsequent U.S. Supreme Court ruling made the expansion optional, according to a University of Washington analysis of the fiscal effects of expansion.
Twenty-five states initially expanded their programs in 2014, according to the report “Analysis of the Fiscal Impact of Medicaid Expansion in Missouri.” Eight states later expanded through legislative action. And four passed ballot initiatives to expand.
So there is a lot of evidence for Missouri to look at if it is to consider expansion, Schantz said.
“Because Missouri did not expand, what did it mean for hospitals? How would expansion have affected hospital closings? How does that affect hospital emergency rooms?” Schantz asked. “Are there people who don’t have (health) coverage who would have coverage if we had expanded?”
The panel discussion will include presentation of two videos — “Medicaid explained: Why it’s worse to be sick in some states than others,” which is 11 minutes long, and “Healthcare for Missouri,” which is two minutes, 20 seconds long.
As an incentive, the federal government paid the cost of expansion for states that did so immediately, for the first three years. Then federal responsibility was to decline to 90 percent over the next three years (into 2020). The federal government pays 90 percent of states’ cost for Medicaid expansion for all the other states that later expanded (and will for those that do in the future).
The University of Washington report concludes, if Missouri expanded its Medicaid program, called MO HealthNet, the effect would be “budget neutral.” It would actually save approximately $39 million in 2020, a relative push for a program that cost $10.3 billion in 2018.
The big savings would come over the next four years, according to the report. Without expansion, state spending on health costs would increase by about $800 million through 2024. However, through expansion, costs would decrease about $100 million over those four years, according to the report. It concludes expansion could save Missouri $932 million over four years.
It is estimated about 230,000 adults would become eligible for Medicaid if Missouri were to expand.
“Medicaid expansion would be available to more than 200,000 uninsured Missourians — including farmers, service workers and small-business employees who make less than 138 percent of the poverty level,” Schantz said.
Healthcare for Missouri — a coalition of voters, patients, medical professionals, businesses and community organizations committed to expanding access to health care to Missourians — is conducting a Medicaid expansion ballot initiative. It hopes to get Medicaid expansion on a 2020 ballot. To assure the initiative is on the ballot, organizers have to collect more than 142,000 signatures by May.
They have already collected more than 100,000 signatures and hope to top 300,000 by the end of the year, Reichard said. The organization expects to collect more than 400,000 signatures in all.
The initiative is available to sign 8:30 a.m.-12:30 p.m. Tuesday through Thursday at the association office, 3325 Emerald Lane in Jefferson City. Check healthcareformissouri.org to find opportunities to get involved in the signature-collecting process.
Reichard’s employer, the Missouri Primary Care Association, is an association of 28 community health centers across Missouri that provide health care for all 114 counties and the city of St. Louis. The centers typically see all sorts of patients — those who are uninsured, with private health insurance, Medicaid and Medicare. Patients typically pay on sliding scales, what they can afford.
“We want to highlight and stress the need for Medicaid expansion,” Reichard said. “What we know is that if a parent or guardian is healthy, the child is likely to live a healthier life.”
And people with coverage are less likely to end up unnecessarily in emergency rooms.
“Every single one of our health centers — the patients they see — they pay something,” she continued. “They don’t receive free care. It’s just affordable care.”
Health centers — community-based organizations that deliver comprehensive and primary health care services regardless of patients’ ability to pay — are united in support of Medicaid expansion, Reichard said. Joe Pierle, the association’s chief executive officer, is also treasurer of the campaign to get the initiative on a ballot, she said.
It is concerning, Reichard said, that Missouri is one of the final 14 states that has not been willing to expand Medicaid and make citizens healthier.
“Other states have placed priorities on the health care needs of people who are most vulnerable,” she said. “Expansion saves states money. It helps the economy. It helps the workforce.”