Government & Politics

Group launches petition campaign to place Missouri Medicaid expansion on 2020 ballot

Groups hoping to make Missouri the 37th state to expand Medicaid officially launched a campaign Wednesday to put the question on 2020 ballot.

In Missouri, the state-run Medicaid program, MO HealthNet, provides health insurance only to children, pregnant women, those with disabilities and some seniors.

Expansion could mean coverage for an additional 200,000 Missourians under the proposal, according to Healthcare for Missouri, the campaign committee leading expansion efforts.

The committee was formed in March and spent the summer exploring whether expansion was possible in Missouri through initiative petition. On Wednesday, it announced it would commit to putting the question in front of voters in 2020.

“I feel so strongly that hardworking Missourians across the state deserve affordable healthcare so that they don’t have to decide between their medications and putting food on the table,” Dr. Heidi Miller, a St. Louis physician and expansion advocate who submitted the petition on behalf of the group, said in a statement.

Signature collection has already begun and signing events have been announced for Kansas City, St. Louis and Jefferson City. Petition backers would need submit 172,000 valid signatures to the secretary of state to be placed on the ballot, according to the statement

The campaign has received financial support from the The Fairness Project, a 501(c)(4) “dark money” political nonprofit that is not required to disclose its donors. In working with local advocates, the organization was able to successfully expand Medicaid in Utah, Nebraska, Idaho and Maine within the last three years, according to its website. It also played a role in the successful push to raise Missouri’s minimum wage to $12 through initiative petition in 2018.

In contributing about $31,000, the Fairness Project is the campaign committee’s only donor so far, according to the Missouri Ethics Commission.

However, the campaign includes supporters like the Missouri Hospital Association, the Missouri Primary Care Association and a similarly named permanent advocacy group, Missouri Health Care for All.

A lack of Medicaid expansion has led to a financial burden of uncompensated care for healthcare providers, who are mandated to serve everyone who comes through the emergency room, regardless of whether they are insured.

At least nine rural hospitals have closed in Missouri since 2014. Of the 590,000 patients Missouri’s Community Health Centers saw in 2018, 144,000 were uninsured, according to the Missouri Primary Care Association.

“Hospital closures in rural communities have increased the distance to lifesaving care for Missourians suffering from traumatic injuries, stroke and heart attack,” Herb Kuhn, Missouri Hospital Association president, said in a statement. “Minutes count in medical emergencies. Medicaid expansion will help maintain access to emergency care in rural Missouri — benefiting those gaining coverage and all rural residents.”

Missouri Health Care for All is grassroots coalition of individuals, local health care providers and faith organizations.

“After years of inaction by the Missouri General Assembly, we are thrilled to reach this moment, when a broad and powerful coalition of Medicaid Expansion supporters can at last say, ‘We are bringing this straight to Missouri voters to decide,’” Jen Bersdale, its executive director, said. “It’s the right thing to do for the more than 200,000 uninsured Missourians who would gain coverage, and it’s the right thing to do for Missouri’s taxpayers, budget, and hospitals.”

Missouri lawmakers have long been reluctant to expand Medicaid, saying that the program already comprises a third of the state’s budget.

Expansion, which is allowed under the Affordable Care Act, would be paid for almost entirely by federal dollars, with the state contributing a 10 percent match.

The initiative petition says it would affect those making below 133 percent of the poverty level. However, because of income considerations built into the law, in practice, it would make Medicaid available to those making less than 138% of the federal poverty level, or less than $18,000 a year for an individual and $30,000 for a family of three, according to Healthcare for Missouri.

*This story has been updated.

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Crystal Thomas covers Missouri politics for The Kansas City Star. An Illinois native and a graduate of the Missouri School of Journalism, she has experience covering state and local government.
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