COLUMBIA — The possibility of expanding Medicaid to cover more low-income families has hung over the Missouri legislature for some time.
Since the U.S. Supreme Court gave states the option to expand Medicaid in 2012, Missouri has opted out.
Expanding Medicaid would make health care more accessible to low-income families, even those without children, according to the Centers for Medicare and Medicaid Services. Homes of four people with incomes up to 138 percent of the poverty line — or $32,499 — would be eligible, according to previous Missourian reporting.
According to the U.S. Department of Health and Human Services, Missouri’s Medicaid enrollment has dropped a little more than 33,000 since July. The department said that if Medicaid were to expand in Missouri, it would insure up to 253,000 people who are currently uninsured. Following procedures outlined in the Affordable Care Act, the federal government would pay 100 percent of costs for the expansion for the next three years, lowering coverage to 90 percent after those three years.
The city of Columbia has expressed support in the past for Medicaid expansion. In December 2013, the city passed a resolution asking state legislature to proceed with expansion. The council said that expanding Medicaid would not only make health care more affordable for low-income families, but also create jobs.
One of the main reasons cited by some Missouri legislators for not expanding Medicaid is the costs the state could incur down the road. Many legislators, mostly Republicans, also disapprove of the Affordable Care Act. Some have said they would reconsider Medicaid expansion if it came with significant reforms.
Candidates for state legislature weighed in with their stance on Medicaid expansion.
- Caleb Rowden: The incumbent Republican who is seeking a second term said the Affordable Care Act in its present form makes it difficult for Medicaid expansion to occur in Missouri. He said he would be open to an expansion that would allow for an overhaul of the current Medicaid system. Rowden thinks, however, that even if reform doesn’t happen, Missouri will probably expand Medicaid eventually, but he’s unsure when. He wants a reform package that would allow the state to expand on its own terms.
- Tom Pauley: The Democratic challenger candidate, who is a health and life insurance agent who sells insurance under the Affordable Care Act, said he wants to expand Medicaid. He said that there is no time to find the perfect reform plan before expanding. He said the only reason the Affordable Care Act and Medicaid have not expanded in the state is because legislators don’t want President Barack Obama to have a victory.
- Kip Kendrick: The Democratic candidate running unopposed said he favors Medicaid expansion and is optimistic it will happen at some point. He said the failure to expand Medicaid has hurt the economy and hindered rural hospitals that have had to cut their budgets.
- Stephen Webber: The incumbent Democratic representative who is running unopposed said Medicaid will have to expand eventually because hospitals would otherwise be forced to close. Webber said that Republicans have cost the state an economic boon and a loss of jobs and that they need to step up and expand Medicaid.
- John Wright: The Democratic incumbent supports Medicaid expansion. Wright thinks the state should expand because it would provide more jobs and more help to families with no health insurance.
- Chuck Basye: The Republican challenger said Medicaid expansion is a federal issue, not one for the state. He said that the current health care system needs reform to eliminate “waste, fraud and abuse.” He thinks people should be allowed to look for insurance in other states, and he favors health care savings accounts.
Source: Columbia Missourian