Over 53% of Missourians voted for Medicaid expansion in August 2020. But now, it appears that the legislature has decided to dismiss the voting public.

How do we explain that Missouri is one of only 13 states that has failed to participate in Medicaid expansion? What do Missouri legislators know that 37 other states don’t know? Gov. Parson is clearly not an advocate of Medicaid expansion, yet stated in 2020 “it’s critical to hear (Missourians') decision,” after he was presented with over 350,000 citizen signatures to place Medicaid expansion on the ballot.

It was a citizen movement in response to the failure of the Missouri Legislature to endorse federal resources for Medicaid expansion beginning in 2014, with the implementation of ACA. The federal government paid the full cost of expansion and, starting in 2017, states gradually started to pay a share of the expansion not greater than 10%. From 2013 to 2022, it is projected that Missouri has given up $17.8 billion in federal funding by failing to expand Medicaid. Why would we turn our backs on funding to ensure Missourians have access to health care?

Washington University made the following estimates of the positive benefits of Medicaid expansion in Missouri: Expansion would deliver health care to an additional 230,000 Missourians, increase economic output by $2.5 billion, create 16,000 new jobs with an average hourly wage of over $15, bring $1 billion of Missourians’ tax dollars back to Missouri, protect rural hospitals and address racial inequities.

Can you imagine trying to afford health care insurance as a single person earning less than $17,699 or a family of four earning less than $36,156 per year? Missourians need access to health care. If uninsured via Medicaid expansion, that is 90% funded by federal dollars and 10% by Missouri, we will continue to pay for uninsured care. Morally, ethically and economically, Medicaid expansion is the right thing to do. Not only that, it is the will of the voters.

Linda Smith is a concerned citizen who lives in Columbia.

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