Missourians will get the final say on Medicaid expansion if a newly-formed coalition is successful in getting the issue on the 2020 ballot.
The campaign, Healthcare for Missouri, is a growing group of doctors, nurses, patients, business executives, and healthcare supporters all with a similar goal: expand the eligibility for government health insurance.
“After years of inaction by the Missouri General Assembly, we are thrilled to reach this moment, when a broad and powerful coalition of Medicaid Expansion supporters can at last say, ‘We are bringing this straight to Missouri voters to decide.’ It’s the right thing to do for the more than 200,000 uninsured Missourians who would gain coverage, and it’s the right thing to do for Missouri’s taxpayers, budget, and hospitals,” Jen Bersdale, executive director of Missouri Health Care for All, said.
Beyond the similarly named, permanent advocacy group, Healthcare for Missouri is backed by the Missouri Hospital Association, the Missouri Primary Care Association, the Missouri Budget Project, and several other organizations.
Petitioners have until May 3, 2020, to deliver signed petitions to the Secretary of State’s Office. Proposed constitutional changes must be signed by 8 percent of legal voters in any six of the eight congressional districts, which amounts to a minimum of 160,199 signatures.
The coalition is gathering signatures Petition 2020-63, which was filed by Heidi Miller.
The ballot language asks voters if they want to amend the Missouri Constitution to adopt Medicaid expansion for folks 19 to 64 years old with an income level at or below 133 percent of the federal poverty level; prohibit greater or additional burdens on eligibility or enrollment standards; and require state agencies to take all actions necessary to maximize federal financial participation in funding.
The income benchmark would be less than $18,000 a year for an individual or $30,000 for a family of three. Advocates argue the measure would help Missourians who earn too much to qualify for existing Medicaid and too little to be able to afford private insurance.
Increased eligibility for the state health insurance program is billed as “the fiscally responsible thing to do as well” by advocates. But opponents to Medicaid expansion have long billed the idea as too expensive, pointing to the increasing cost of Mo HealthNet, which already accounts for one third of the state budget.
However, the fiscal reality is difficult to pinpoint.
Per the fiscal note calculated by the state auditor, state government entities are estimated to have one-time costs of roughly $6.4 million and an unknown annual net fiscal impact by 2026 ranging from increased costs of at least $200 million to savings of $1 billion.
Supporters point to rural hospital closures — nine in Missouri since 2014 — as a reason to expand Medicaid eligibility.
“Hospital closures in rural communities have increased the distance to lifesaving care for Missourians suffering from traumatic injuries, stroke and heart attack,” said Herb Kuhn, president and CEO of the Missouri Hospital Association. “Minutes count in medical emergencies. Medicaid expansion will help maintain access to emergency care in rural Missouri — benefiting those gaining coverage and all rural residents.”
Of the 36 states that have expanded Medicaid, three have done so at the ballot, seven have used a 1115 waiver, and 26 have gone the traditional legislative route.
Following the official launch of the campaign, Healthcare for Missouri raised $1.3 million. Donations to the campaign include $750,000 from the Health Forward Foundation, $396,465 from Prospects for Missouri, and $250,000 from BJC Healthcare.
Since the committee was formed in July, it’s first quarterly finance report with the Missouri Ethics Commission will be in October.