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Healthcare for Missouri logging miles in campaign for Medicaid expansion

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Medicaid Expansion Missouri

Campaign workers David Woodruff, left, and Jason White, right, deliver boxes of initiative petitions signatures to the Missouri secretary of state’s office in Jefferson City on Friday, May 1, 2020.  (AP Photo/David A. Lieb)


JOPLIN, Mo. — Healthcare for Missouri may be driving to a neighborhood near you with its Medicaid Ambulance Response Vehicle, which has covered 8,000 miles since May pushing for the Medicaid expansion proposal that will be on the Aug. 4 election ballot.

Missouri’s Medicaid program currently doesn’t cover most adults without children and has one of the nation’s restrictive income eligibility thresholds for parents, according to Healthcare for Missouri. The ballot proposal would expand coverage to adults earning up to 138% of the federal poverty level, which is about $17,600 annually for an individual or $30,000 for a family of three.

With the election only weeks away, the Healthcare for Missouri coalition has made frequent stops throughout the state to campaign for Amendment 2, which would deliver health care to 230,000 Missourians. On Tuesday, the campaign vehicle stopped in Lamar and Joplin to give out yard signs, buttons and offer information about the initiative.

“The ambulance was donated to us, and we were able to get it wrapped in all of our messaging,” said K.J. McDonald, field director with Healthcare for Missouri. “It’s kind of like a driving billboard. We’ve been taking it all over the state across the last couple of months.”

The Missouri Hospital Association, the Missouri Nurses Association, the Missouri Primary Care Association, Freeman Health System and Mercy Hospital Joplin have also cited support for the expansion. Medicaid expansion supporters say it will help keep rural hospitals open, which are having to foot the bill when people without insurance are unable to pay for emergency care.

“It will strengthen our hospitals, add jobs to our economy and save our state budget money in the long run by covering more people,” McDonald said. “It’s fiscally responsible and morally the right thing to do. We’ve seen 10 rural hospitals close since 2014, and many of those hospital administrators have said that Medicaid expansion would’ve likely saved their hospitals from closing.”

Its passage would save the state up to $1 billion annually by 2026, according to the office of Democratic Auditor Nicole Galloway, who is a candidate for governor. A fiscal impact study conducted by Washington University also supports expansion.

Opponents of proposal

A Missouri judge recently dismissed two lawsuits against the ballot proposal to expand Medicaid.

The lawsuits by conservative advocacy group United for Missouri and Americans for Prosperity-Missouri sought to knock the proposal off the Aug. 4 ballot. Both groups said the proposal would expand the government health insurance program without coming up with a funding source for it.

“The costs to cover Medicaid expansion will come directly off the top of the budget without any regard to available funds and the Legislature will have absolutely no discretion over this spending,” said Ryan Johnson, a senior adviser to United for Missouri, in a statement. “The proponents mention cost savings, but the department that operates the state Medicaid program on a day-to-day basis says it will cost state taxpayers at least $200 million. If the worst-case scenario plays out and the federal money goes away, Missouri taxpayers will be left behind to forever cover the entire annual bill of $2 Billion. This is wrong.”

Americans for Prosperity-Missouri also said the ballot initiative violates constitutional requirements because the initiative would require appropriating money to fund the proposal.

“This mandate will divert critical funds from our children’s education or force the state to increase taxes,” said Jeremy Cady, state director for the American for Prosperity-Missouri, in a statement. “At a time when our state is already in dire economic straits, we should not tie the hands of the Legislature with this unconstitutional ballot initiative.”

But Cole County Circuit Judge Daniel Green ruled on June 2 that the ballot measure doesn’t require lawmakers to set aside state revenue for the expansion. That means the measure will stay on the ballot. Both critics of the proposal say they will appeal.

Support for Amendment 2

Proponents believe Medicaid expansion would save the state money in the long run. Donna Harlan, of Joplin, attended the campaign stop Tuesday in the parking lot of the Community Clinic of Southwest Missouri in Joplin to pick up yard signs. Harlan said she’s been working with the coalition for some time in order to get Medicaid expansion on the ballot.

“People are in a gap,” she said. “Even with minimum wage, in order to even live, you make more than it takes to get on Medicaid, but quite often, you don’t make enough money to get ACA. There’s a big gap in health coverage. Particularly with COVID-19, it’s essential we get people the help that they need. We’ve been working on this for quite a while.”

The Missouri Chamber of Commerce, one of Missouri’s most influential business groups, announced support for Amendment 2. President and CEO Daniel Mehan cited a study that suggests expanding eligibility for the government health care program would create more than 16,300 jobs annually in the first four years of the program. The study was done by Massachusetts-based economic analytics firm Regional Economic Models Inc. and commissioned by the Missouri Foundation for Health.

The chamber’s support is significant because the organization plays a major role in Missouri politics and has particular sway among Republican elected officials, many of whom — including Gov. Mike Parson — oppose Medicaid expansion.

The Associated Press contributed to this report.

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