More than 720,000 Missourians have no health insurance, but Missouri has an unusual and wonderful opportunity to make a significant advance in solving this problem.
Governor Jay Nixon and the Missouri Hospital Association have devised a creative, financially sensible solution. The hospitals have agreed to tax themselves $52.5 million and use that money as the match to draw more than $90 million of federal funds to Missouri. If this historic agreement were to be adopted by the legislature, the money would then be used to extend health care coverage to nearly 35,000 adults, all of whom are parents and all of whom are below 50 percent of the poverty level.
Hospitals currently receive federal funds to treat poor, uninsured patients. People without any way to pay for health care — thousands of Missourians — go to the emergency room as their first point of medical contact. But emergency care is much more expensive for hospitals — and patients — than routine, non-emergency care in doctors’ offices or public health clinics.
The hospital association, therefore, thought it was both in its fiscal interest and in the health care interests of thousands of Missourians to help solve the problem. It reached an agreement with Gov. Nixon to pay the state $52.5 million per year, $14 million more than it is currently paying. This payment would allow the state to qualify for an additional $93 million in federal matching funds. If Missouri does not apply for these matching dollars, the $93 million in federal dollars is simply allocated to another state’s health care system.
To emphasize — the hospitals pay the state $52.5 million, generating a federal match to the state of $93 million. Missouri is $145 million per year better off. More importantly, these funds would allow 34,800 low-income adults to receive needed, primary, Medicaid-eligible health care.
This increase in health care can be accomplished with no new state general revenue and no stimulus dollars. It is not a temporary solution. It is a permanent solution. It incurs no future obligation to the state.
All the state legislature has to do is to raise the Medicaid eligibility limit to 50 percent of the federal poverty level. Missouri caps Medicaid eligibility at 20 percent of the federal poverty level — for a family of four, that’s a maximum income of $4,410 per year. If the Medicaid eligibility level were raised to 50 percent of the federal poverty level, a family of four earning up to $11,025 per year would then be eligible.
Every reasonable Missourian will understand that providing medical coverage to low-income working parents makes sense when we can do so at no new cost to Missouri taxpayers. Being poor or being out of work should not make a family any less deserving of health care than the families of state legislators. Let’s not let a commonsense solution to a serious problem be thwarted by blind partisanship.
The Democratic minority members of the House of Representatives can’t do it alone — the numbers aren’t with us. We don’t have the votes. It’s up to the people of Missouri to convince the Republican majority that they’ve gone too far; that working people need health care; and that we are all better off for it.
Chris Kelly is the state representative for Missouri's 24th District, which includes Columbia.