JEFFERSON CITY, Mo. — On Monday, five state senators took the floor to re-iterate their opposition to Medicaid expansion. The lawmakers said they would block any effort to expand the program under the Affordable Care Act.
That same day the Republican-controlled House continued hearings on a bill that would do just that. Rep. Noel Torpey, R-Independence, is sponsoring a bill that would expand Medicaid eligibility to 138 percent of the federal poverty level as called for under the ACA. Torpey’s bill also contains a number of reform provisions typically favored by conservatives, like some work requirements.
As Republicans continue to battle within their majority on how to handle expansion, most groups lobbying for the expansion have taken to leaving financial discussions to hospitals and healthcare providers. Groups like Missouri Health Care for All came to Torpey’s hearing with witnesses that would benefit from expansion.
Jeri Smith Landon and Jamie Kanan both fall into the “donut hole,” left by states that have not expanded Medicaid. Both women make too much qualify for current Medicaid eligibility and too little to afford insurance through the ACA exchanges. Individuals that fell into the donut hole would be covered if Medicaid eligibility were to expand.
“I always hear [lawmakers] talk about the people who sit around and do nothing and get Medicaid,” Kanan said. “But what about me? I work full time in home health care and I work an extra job as well and I have five kids. I’m not just sitting around, I’m working.”
Kanan has five children and was the victim of an abusive relationship. As the result of injuries received from her ex-husband, Kanan has chronic back pain and leg numbness. She says it is getting worse, but only surgery can fix the problem, surgery she can’t afford.
“I have head trauma too, a lot, from being hit so many times,” Kanan said. “I know I need to see a neurologist but I can’t afford it, I don’t know what I’ll do if it gets worse.”
Kanan is the Washington County low-income representative for the East Missouri Action Agency, works at the Mineral Points Lions Club and chairs the Mineral Point Back to School program. She says she’s been told she could apply for disability but that she doesn’t want to at 29.
“I don’t want to be disabled, I want to get better.”
Landon, from Camden County, has a similar tale. Landon lives with her husband who recently became disabled, her disabled adult daughter and her adopted 17-year-old grandson. Landon says her income situation is so dire that she no longer takes high-cholesterol medication recommended by her doctor.
“It’s $38 a month and I truly can’t afford that,” Landon said. “That’s money that feeds my family. That money being spent literally means less food for us.”
Landon’s grandson, whose parents died, suffers from severe trauma associated with their death. He was able to visit a psychiatrist under Medicaid, but fears that at 19, he’ll no longer have that option. Landon fears the worst. Ironically, Landon’s work involves caring for the disabled, and she is paid through Medicaid.
“It’s that uncertainty that is so hard; it just weighs on you,” Landon said. “You don’t know what’s going to happen. And if anything happens, anything, there’s nothing for us to count on. We’re just out in the wilderness.”
Landon and Kanan, along with Missouri Healthcare for All, visited fence-sitting lawmakers throughout the day. According to Executive Director Jen Bersdale, the first senator the group visited cried.
“If these lawmakers want to stand up and say they won’t do this, then I think they least they can do is look these women in the eye and say why,” Bersdale said. “There’s a solution out there to give these people healthcare. If they don’t like it, then what’s the alternative plan? What’s your plan if not this?”
If a combination reform and expansion bill could survive the conservative Republican House — far from guaranteed — it would face it’s greatest uphill battle in the Senate. The upper chamber’s interim committee on Medicaid concluded that no expansion would even be considered until sweeping reforms were passed. It’s unclear whether Torpey’s bill would mollify some of Medicaid expansion’s biggest opponents.
Bersdale’s group brought more than 2,100 testimonial forms favoring expansion. Landon and Kanan both said they felt lawmakers were respectful and even sympathetic to their testimony. Torpey’s bill has not yet been voted on in committee, and even more testimony and discussion is expected.