The Star recommends a yes vote on Missouri Amendment 2 to finally expand Medicaid

On Aug. 4, Missouri voters should overwhelmingly and enthusiastically vote yes for Amendment 2, the Medicaid expansion plan.

There are many reasons to support Amendment 2. Here’s the most important: It could provide health insurance, and better health care, to 250,000 low-income Missourians.

It’s the right thing to do under any circumstances. In the middle of an historic pandemic, it’s a moral imperative.

Medicaid expansion should not be a partisan issue, and indeed, business groups, medical associations and religious organizations are backing the measure that will provide more families access to health care.

As the Missouri Medicaid Coalition, one of several groups promoting passage of the measure, notes, “A healthier population is more productive, makes families more secure, and leads to a stronger and more vital economy.”.

Opponents such as Missouri GOP Rep. Cody Smith, the chairman of the House Budget Committee, have urged Missourians to vote no because “we can’t afford to expand Medicaid.”

Let’s do some math.

The federal government will pay 90% of the cost of expanded Medicaid, with Missouri picking up the other 10%. Missouri’s share, according to some estimates, could be $200 million a year.

It isn’t clear the program will cost anywhere near that amount. Expanded Medicaid will inject more than $2 billion into the state’s economy, almost certainly creating new jobs and state taxes to cover the cost. In fact, expanded Medicaid could actually save the state $1 billion, according to some projections.

But even if expanded Medicaid were to cost $200 million, it would still be worth the price. That’s just 2% of the state’s general budget. Two percent — to give 250,000 low-income Missourians quality health care.

It’s too expensive? Missourians are already paying for their uninsured neighbors. When someone without insurance seeks treatment, the cost is passed on to everyone through higher insurance premiums and bigger health bills. By expanding Medicaid, insured Missourians may actually save on their health care costs.

There are other compelling arguments for expanding Medicaid:

▪ Rural hospitals are closing across Missouri, and more insured patients may help keep those hospitals open if Medicaid is expanded.

▪ A better Medicaid program will improve mental health treatment in Missouri; growing evidence suggests that could lower the violent crime rate.

▪ More Missourians will be able pay to see a doctor, which could slow the spread of COVID-19.

Supporters of Medicaid expansion note that 37 states and the District of Columbia have expanded Medicaid, or are getting ready to do so. Missourians can take advantage of the same opportunity without increasing their federal tax burden.

There is no reason why Missourians should shoulder the burden of reducing the federal deficit while other states expand their Medicaid programs. That’s just common sense.

That’s why business groups, including the Missouri Chamber of Commerce, have endorsed expansion. Labor groups, hospital and doctors’ associations, religious groups, and medical care societies such as the American Cancer Society have all endorsed Amendment 2.

Voters should remember their yes vote will amend the state’s constitution, making it very difficult for recalcitrant lawmakers to abandon the working poor. That’s a feature, not a bug.

Missourians are fiercely protective of their right to seek laws through initiative petitions. This election is precisely why: Obstructionists in Jefferson City, blinded by their hatred of Obamacare, have routinely blocked consideration of expanding Medicaid. They have ducked their responsibility time and again.

In Missouri, when that happens, the people can go around the legislature and the governor and make their own laws. Now is the moment to do just that.

We first suggested a statewide referendum on expanding Medicaid in November 2017. From that day to this one, we have argued relentlessly for expansion. There is no reason to change our minds now, or for Missourians to waver in their commitment to fairness for all.

Vote yes on Aug. 4 for Amendment 2.

This story was originally published July 27, 2020 at 5:00 AM.