As you may have heard, Missouri has been shrinking its Medicaid rolls, relieving 120,000 people — including 95,000 low-income children — of their health insurance since January of last year.
This retrenchment, the third-largest drop-off in the country, is even more dramatic given that the state already has one of the nation’s most narrowly drawn programs, offering insurance only to children, pregnant women, some seniors and Missourians with disabilities.
Mostly, this mischief has been accomplished by making it harder for people to re-enroll. What state officials call “cleaning up the rolls,” those who’ve lost coverage describe as confusing paperwork, sometimes sent to the wrong address, backed up by “dysfunctional” call centers. The only theoretically recently upgraded Missouri Eligibility Determination and Enrollment System “brings significant new functionality to our state,” one MO HealthNet official said. Is that what they’re calling it now? More like significant new shame.
Instead, the state should be expanding Medicaid.
The refusal of both Missouri and Kansas to do that leaves the most vulnerable among us sicker, federal dollars (from Missourians and Kansans, of course) spent elsewhere, rural hospitals struggling — nine have closed in Missouri in the last five years — and mental illness treated largely in jails.
If lawmakers really thought that mental illness, which afflicts people the world over, explained much of the current epidemic of gun violence in the United States — and no, it doesn’t — then the first thing they’d do is expand Medicaid, and with it treatment programs for those who can’t otherwise afford it.
But since that’s not happening, and Republican Missouri lawmakers have shown even less willingness to consider an expansion than their Kansas counterparts, we hope voters get to decide next year.
They’d need to present 160,199 valid signatures to Missouri Secretary of State Jay Ashcroft to get the measure on the ballot. (And do we even need to say they should get those signatures in early to avoid a repeat of the way Ashcroft deprived voters of the chance to vote on the state’s new abortion law next year?)
Because we all pay already, in higher health care costs, for the uncompensated and inefficient care that the uninsured receive in hospital emergency rooms, the argument that we can’t afford to expand Medicaid has never made any sense.
Our lawmakers in Jefferson City cannot be reasoned with. But voters, you know what to do.