For a decade now, Missouri’s Republican-ruled Legislature has been sabotaging the health of some of the state’s most vulnerable citizens. The GOP’s refusal to expand Medicaid, as envisioned under the Affordable Care Act, has denied this valuable benefit to, by some estimates, more than 250,000 Missourians who could become eligible. For an estimated 87,000 of the state’s citizens, there is no other realistic option for health insurance at a time when coverage is more essential than ever.
When people don’t have health insurance, they don’t go to the hospital until the situation is dire enough to go to an emergency room. The Legislature’s refusal to expand Medicaid has undoubtedly cost lives. And for what? Because legislative Republicans were obsessed with the purely political goal of ensuring the failure of then-President Barack Obama’s goal of near-universal health care.
Now, there’s a chance to do something about it. Amendment 2, on the Aug. 4 ballot, would write Medicaid expansion into the Missouri Constitution, taking it out of the hands of the GOP’s health care saboteurs. For many Missourians, passage is, literally, a matter of life or death, which is why an overwhelming “yes” vote on Amendment 2 is essential.
America has long been a holdout as virtually the only advanced nation in the world that still treats health care as a market commodity rather than a right. Congress passed the Affordable Care Act, or Obamacare, in 2010 to incorporate both the private insurance market and existing government programs like Medicaid. But Obama underestimated the cynicism of a Republican Party dedicated to ensuring his signature program crashed and burned.
In 14 red states, including Missouri, it meant refusing to expand Medicaid, the federal-state health care program for the poor, even though the federal government bore the brunt of the expansion costs. Washington initially paid the full expansion costs, with individual states gradually taking on 10% of it annually.
For Missouri, the ACA was a chance to strengthen one of the lowest Medicaid eligibility rates in America. Parents with dependent children are eligible for Medicaid health care coverage in Missouri if they earn up to 22 percent of the federal poverty level, or around $4,700 per year for a three-person household. Adults without children aren’t eligible at all. Under the ACA expansion, that eligibility would rise to 138% of the poverty level, or earnings of about $35,500 annually per family, and would allow childless individuals to enroll if they earn less than about $18,000.
Even with the state bearing 10% of the total expense, the proposition is a bargain for Missouri, because a healthier population is less of a drain on state coffers in myriad ways. Yet Missouri Republicans refuse to budge, arguing — incredibly — that a lifesaving health benefit paid 90% by the federal government in perpetuity isn’t worth it.
Some 350,000 Missourians expressed how much they disagree by signing petitions to get the question onto the November ballot. That’s about twice the number of signatures legally required.
In a calculated move, Republican Gov. Mike Parson pushed the vote up to August’s primary ballot instead of the higher-turnout ballot in November. A loud-and-clear victory for the amendment would tell that cabal of ideological extremists in Jefferson City that this state is, at last, ready to join the 21st century.