GUEST COMMENTARY: Drop the politics and expand Missouri's Medicaid program

Friday, December 7, 2012 | 3:36 p.m. CST; updated 8:17 p.m. CST, Saturday, December 8, 2012

"This is not a political issue for us ... this is the real world."

Those are the words of Joe Pierle, head of the Missouri Primary Care Association. He is talking about a debate over whether the state should accept the federal government’s deal and expand Medicaid eligibility.

The election is over, but the debate continues to sound like the same anti-Obama electioneering we heard all year. It is time to quit treating this like a “political issue” and start thinking about the realities that would likely follow if the state turns down that deal.

The issue of Medicaid expansion began when the Affordable Care Act — Obamacare — passed. The national healthcare plan included a drop in Medicare reimbursements to hospitals in exchange for adding about 30 million people to the Medicaid rolls around the country. But the U.S. Supreme Court, when it found the act to be constitutional, rejected the requirement for states to follow the Medicaid guidelines.

Medicaid is a federal-state program, with states setting the standards for eligibility. In Missouri, a family of four is eligible for Medicaid if the family’s annual income does not exceed about $4,380. Under Obamacare, that same family could earn $31,809, and the state would add as many as 300,000 people to its Medicaid rolls.

The cost of doing that has state lawmakers worried. Although the federal government will foot the bill for the first three years, then 90 percent of the cost within six years, the cost to the state has been estimated at $431 million in that time. However, an MU study concluded that those costs would be offset by cuts in unemployment — the change would create 2,043 jobs in the Ozarks and could add $9.6 billion to the state’s economy in 2014 alone.

These numbers sound very good — more jobs, more money — but even more exciting are the possibilities this could mean for the health of Missourians, especially the working poor. We have been warned that without it, rural hospitals are likely to close. And we’ve been told that thousands of people — those unable to get insurance but not destitute enough to qualify for Medicaid in Missouri — would be able to get basic health care.

Gov. Jay Nixon, the state chamber of commerce, the Missouri Hospital Association and other medical groups all support expansion. Conservative opponents are pushing legislators to turn it down.

It is time to stop the politics. The real world issue is that we need to take the deal and start caring for the poor and sick in Missouri.

Copyright Springfield News-Leader. Reprinted with permission.

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