The Challenge of Caring for Low-Income Residents

Will the new legislative session that began in January include talks to bring Missouri up to the funding levels of other states by expanding Medicaid?

Bert Malone has been with the Kansas City Health Department for 11 years and he is now deputy director for the department. He said he also had worked with the Missouri Health Department for 15 years and before that, with the Centers for Disease Control. So he has experience at the local, state and federal levels, making him a good person to ask about the effects of a Medicaid expansion.

People sometimes get confused about the differences between Medicare and Medicaid. Malone explained: “Medicare is designed to help the elderly. Medicaid is for those individuals that are under such financial constraints that they don’t have access to health care under their own insurance or public care in hospitals.”

“I think there will be a strong push in the Missouri General Assembly to expand or transform, which is the word that many in the majority party choose to use, Medicaid for Missouri,” Malone said.

He said that under the Affordable Care Act’s initial passage, all states were required to expand Medicaid to up to 138 percent of the federal poverty level. “The Supreme Court upheld all aspects of that law in June 2012 except for that provision,” Malone said. “They ruled that it was unconstitutional and that the federal government couldn’t mandate how state governments spend their dollars. To this date, 29 states have expanded Medicaid, but Missouri is not one of them, nor has Kansas.”

Malone said that Missouri Gov. Jay Nixon has come out in favor of a Medicaid expansion for the state. A lack of Republican votes has caused previous efforts to expand Medicaid to fail in Missouri’s House and Senate.

The Kansas City Health Department has created talking points on why Medicaid expansion would be good for Missouri. Some reasons the department cited are:
• About 260,000 more residents would have access to health insurance.
• Health dollars would be spent more effectively by reducing an average of $1.1 billion per year in uncompensated care costs for hospitals and clinics that currently serve people without insurance.
• It would cost Missouri more to not expand Medicaid.
o Medicaid expansion brings funding to the state.
o Expansion saves the state money on uninsured care.
o Expansion creates jobs, spurring the state’s economy.
The talking points also say that in the first year alone, the
Medicaid expansion would save Missouri at least $47 million and over 10 years, it would save the state $348 million in state tax dollars. Federal money from the Medicaid expansion would also bring $2 billion to the state by 2021. The expansion is expected to create 24,000 new jobs for Missourians, which would help the economy.

As it stands now, Malone said, “The ceiling [to qualify for Medicaid> in Missouri is so low that it primarily covers women with children and seniors in nursing homes with no other means of support. The vast majority of Medicaid recipients in Missouri right now are young moms. We’d like to see that expanded to include other individuals that have need for health services and preventive services.”

Missouri voters can tell their legislators their opinion on Medicaid expansion by using this link provided by Missouri Health Matters: Missouri Health Matters

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