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Opinion: The diagnosis is in: Vote no on ObamaCare expansion


On Tuesday, Aug. 4, Missourians will go to the polls to vote on Amendment 2, a proposal to put Obamacare Medicaid expansion in our Missouri Constitution. The consequences of this dramatic expansion of government-run health care would be catastrophic for our state budget and for other state programs. Indeed, we need not look further than our neighbors to see the devastating effects of ObamaCare expansion. 

In 2013, Illinois decided to expand Medicaid after so-called experts assured state leaders that it would only cost $460 million per year and only 342,000 able-bodied adults would ever sign up. After just three years, budget overruns reached 101 percent, costing taxpayers a whopping $923 million per year, and more than 650,000 able-bodied adults — double the expected number — had enrolled into Medicaid. 

State Sen. Bob Onder

Similarly, in 2014, Arkansas expanded Medicaid. State leaders promised taxpayers that it would cost only $180 million per year, and at most, only 215,000 would enroll in the program. After less than three years, the program was already costing taxpayers $323 million per year, and nearly 325,000 able-bodied adults were receiving welfare. 

Overall, states that have expanded ObamaCare have enrolled twice as many able-bodied adults than were ever expected to be eligible, per-person costs have exceeded estimates by 76 percent, and total cost overruns have reached 157 percent. The diagnosis is clear — ObamaCare destroys state budgets, and there’s no reason to assume that Missouri would be spared the same fate. Factor in budget shortfalls we’re seeing due to COVID-19, and this is a recipe for disaster. 

Even without Obamacare Medicaid expansion, in 2018, the program accounted for 39 percent of Missouri’s state budget — more than education, corrections, and transportation combined — and cost taxpayers more than $10 billion. Our Medicaid program is already generous, with nearly 900,000 Missourians currently enrolled. But Medicaid was designed for seniors, children, pregnant women, and other truly needy populations — not for able-bodied adults who are physically and mentally fit for work. If we expand Medicaid, we’re looking at nearly 600,000 able-bodied adults enrolling in the program. And over 60 percent of these individuals already have private health insurance that they will be forced off of if Amendment 2 passes. 

Where will Missouri find the $349 million per year to pay for the expansion of Medicaid? From either cuts in existing programs — elementary and secondary education, higher education, transportation, public safety — or from massive tax increases.  

Since 2014, we’ve already seen 14 hospital closures all around the state, especially in rural areas.  Although Medicaid expansion is sometimes sold as a panacea for rural hospitals, if patients with private insurance are forced onto Medicaid, conditions for rural hospitals could get even worse. We’ve seen doors closed, jobs lost, and truly needy patients left without care. In fact, hospitals in non-expansion states have actually seen faster hospital job growth.

Amendment 2 is wrong for Missouri. ObamaCare expansion is wrong for Missourians. Expanding Medicaid will burst our state budget, create an enrollment explosion, and send costs skyrocketing. Let’s learn from our neighbors, not fall into the same trap. Vote no on Aug. 4.