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JEFFERSON CITY — Washington University has put big money behind its support of Medicaid expansion in Missouri, contributing $250,000 on Friday to an effort that would place a question on next year’s November ballot.

The check to Missourians for Healthcare came after Chancellor Andrew Martin and Dr. David Perlmutter, dean of the School of Medicine, on Nov. 4 issued a joint letter endorsing the ballot initiative.

Caroline Arbanas, spokeswoman for Washington University, said the $250,000 came from funds within the School of Medicine.

“For those dealing with serious illnesses, such as cancer, diabetes or heart disease, access to medical care is often a matter of life or death,” the Nov. 4 letter said. “Every day, we see patients at the Medical Campus who arrive with late-stage terminal illnesses that might have been prevented with earlier treatment.”

Under the plan, if placed on the ballot and approved by voters, the public health insurance program would be available to those earning up to $18,000 per year. Missouri is one of 14 states that have not expanded Medicaid.

The campaign must collect approximately 172,000 signatures by May to place the question on next November’s ballot. Organizers said earlier this month they had collected about a quarter of the required signatures.

States will be responsible for 10% of the cost of Medicaid expansion next year, with the federal government paying the other 90%.

Opponents in the GOP-controlled Legislature argue the state would have to cut support for education in order to fund the program, but proponents say savings through expansion would outpace costs.

Other Republican-led states, including Utah, Nebraska and Maine, have opted to expand Medicaid through initiative petitions after state Republicans had for years resisted expansion.

Missouri Gov. Mike Parson, a Republican, hasn’t said whether he’ll sign the petition. His likely opponent next year, state Auditor Nicole Galloway, a Democrat, supports Medicaid expansion.

Washington University’s contribution was just the latest big-dollar donation to the effort.

Other large contributions include $500,000 in September from the Washington, D.C.-based North Fund, which doesn’t have to reveal its donors, as well as $500,000 from the Missouri Hospital Association and $250,000 from BJC HealthCare.

No committee has emerged to oppose Medicaid expansion.

This isn’t the first time Washington University has ventured into politics.

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The National Association of Independent Colleges and Universities says that under federal tax law, private colleges can support “nonpartisan election-related activities” but can’t donate to political candidates without risking their tax-exempt status.

Washington University retains 11 lobbyists, according to the state ethics commission.

This year, the university opposed a failed legislative effort that would have changed how public and private universities handle claims of sex discrimination.

The university supported failed efforts in 2002, 2006 and 2012 to raise the state’s tobacco tax, Arbanas said, as well as opposing a 2016 tobacco tax initiative.

She said the school in 2010 supported a sales tax increase in St. Louis and St. Louis County to fund public transportation. The school also supported a ballot initiative in 2006 that allowed embryonic stem-cell research in the state, Arbanas said.

“These ballot initiatives were ones having a major impact on the University’s core mission of teaching, research, and clinical care,” she said in an email.

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