Data-Driven Case for Missouri Medicaid Expansion

Next week, Missouri voters will face a choice on whether to expand Medicaid throughout the state. Luckily for voters, there are plenty of case studies to look to when deciding which way to vote. Over two-thirds of US states have already expanded Medicaid, and the enormous economic and health benefits are clearly demonstrated across the nation. The expansion of Medicaid in Nebraska in 2018 has not incurred a funding burden to this point in its implementation and is providing health insurance for more than 100,000 Nebraskans who otherwise would not have had coverage during the current COVID-19 pandemic. In Louisiana, $199 million was saved in 2017 alone through Medicaid expansion. Of the 37 states that have expanded Medicaid, none of them have reversed course and net positive outcomes have been realized across the country.


In Missouri, the potential advantages of expanding Medicaid include significant job growth, the influx of millions of dollars to our state budget, and improved access to care for thousands of Missourians. Medicaid expansion is vital in more rural parts of Missouri, which have seen many local hospitals close in recent years. Hospital systems throughout the state, as well as the Missouri Hospital Association, have endorsed Medicaid expansion, encouraged by reports from other states which have shown up to a 55% reduction in uncompensated-care losses as well as significant decreases in the number of uninsured patients throughout the state. An estimated 230,000 Missourians would be eligible for Medicaid benefits under the expansion, many of whom currently make less than 138% of the federal poverty level (up to $18,000 for individuals) but are currently in a "coverage gap" – where they make too much to qualify for Medicaid but can’t afford insurance through the Marketplace. Health outcomes for those who received Medicaid benefits have been shown to be much better than for those who are uninsured.


But what about the burden on Missouri taxpayers? Medicaid expansion will actually not cost local taxpayers any additional tax dollars; it will instead repurpose federal tax dollars paid by Missourians to be spent on Missourians. Missouri has already passed up nearly $18 billion in federal funding by failing to expand Medicaid. Statewide, economic and business leaders alike are in favor of Medicaid expansion. The Missouri Chamber of Commerce has endorsed Medicaid expansion as a “pro-jobs measure that will help fuel economic growth throughout our state.” Key to earning the endorsements of pro-business groups was a recent report from Missouri Foundation for Health on the economic impact of expanding Medicaid. The report found that the expansion would add over 16,000 quality ($15+/hour) jobs over the first five years as well as increase the state’s economic output by over $2.5 billion annually. A significant number of the new jobs will be in regions outside of the St. Louis and Kansas City areas, including rural communities. Another report from the Center for Health Economics and Policy at Washington University in St. Louis concluded that the state would actually save up to $1.3 billion by 2026, as receiving additional federal dollars would offset increased state health spending.


From protecting and expanding the healthcare coverage of our most vulnerable citizens to providing jobs to thousands and bringing federal tax dollars back to Missourians, Medicaid expansion does it all – and then some. Providing life-saving health insurance to low-income Missourians is more vital now than ever, as many of those who are at increased risk of contracting and dying from COVID-19 are those who would benefit from Expansion, especially those who are Black or Hispanic. More than 500,000 Missourians have lost their jobs during this crisis – which means they have also lost access to employer-sponsored health coverage. During the difficult economic and health challenges that we are currently facing, Medicaid expansion is not just the smart economic choice to make, but the ethical choice as well. This is why Simply Strategy joins many of our most valued partners in saying that we endorse voting YES on Amendment 2 on August 4.



~ Dorothy


For a list of those who have endorsed Amendment 2, see here.


Additional list of resources can be found here.

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