Missouri should take the new Medicaid funds
The Kansas City Star
A crucial choice for Missouri lawmakers came more sharply into focus Wednesday with the release of a study suggesting the state would achieve a major economic boost by expanding its Medicaid limits.
The report, financed by the Missouri Hospital Association and Missouri Foundation for Health, said 22,000 sustainable jobs would be created over seven years if the state conforms to the Affordable Care Act and raises its Medicaid limits to 133 percent of the federal poverty level.
Other findings: An expansion would bring $8.2 billion in federal dollars into the state between 2014 and 2020. The economic activity spurred by that money would generate nearly $856 million in state and local taxes. About 221,000 Missourians who currently have no health insurance would be eligible for coverage.
And this: Missouri families who have health insurance would achieve savings of $1,688 over the seven-year period, as hospitals and other medical providers would no longer shift the cost of care for uninsured patients onto private insurance premiums.
The research, conducted by The University of Missouri School of Medicine, estimates that expanding the limits would cost the state $333 million from 2014 to 2020.
But that doesn’t account for savings state government would achieve by insuring more low-income people. It would save millions of dollars on mental health expenses and payments to hospitals that care for uninsured patients, for instance. Even without the offsets, the cost to the state would be less than the new tax revenue researchers expect the expanded limits to generate.
Missouri hospitals obviously have a big stake in raising Medicaid limits above 19 percent of the federal poverty level — one of the lowest thresholds in the nation. Federal payments to hospitals that care for uninsured patients are scheduled to be phased out under the Affordable Care Act. If lawmakers refuse to bring more patients under the Medicaid umbrella, hospitals would be left to provide care for uninsured patients without sufficient reimbursement.
Critics in the Missouri legislature will likely quibble with the conclusions of the hospital association’s study. But it’s impossible to argue that the infusion of $8.2 billion in federal money won’t create an economic bounce. Clinics will be built and expanded, suppliers of medical goods will see more business, and the market for nurses, doctors and other practitioners will expand.
That logic obviously appeals to the Missouri Chamber of Commerce. Though no fan of the Affordable Care Act, the chamber is endorsing the Medicaid expansion.
Gov. Jay Nixon, a Democrat, is expected to make a major announcement regarding health care today. A show of support for expanded Medicaid limits would be a positive prelude for his second term.
That would leave the Republican-controlled legislature as the remaining holdout. Leaders there disdain the federal health reform law and are loath to accept money from Washington. But they should also be challenged to explain to their communities why they seem determined to turn down money that would create thousands of jobs, and why they would leave rural hospitals teetering on the edge of bankruptcy.