Vote Yes on Amendment 2, August 4th

By Kjersti McDonald

Missourians have taken a monumental step and successfully placed Medicaid expansion – known officially as Amendment 2 – on the August 4th ballot this year. 

Since the fall of 2019, grassroots organizers and volunteers all over the state gathered nearly 350,000 signatures on petitions to propose this issue be put to the voters. This is not an easy feat. As one of the organizers who recruited and mobilized volunteers in SWMO, I can definitively say that working up the courage to ask strangers to sign a petition takes determination and persistence. But we did it, because we knew it had to be done. 

The assumption was that the ballot measure to expand Medicaid would be on the November 2020 ballot (much like the many ballot measures we saw on the November ballot in 2018 – like Amendment 1, minimum wage increase, and medical marijuana). However, on Tuesday, May 26th, during his daily COVID-19 briefing, Governor Mike Parson announced that Amendment 2 will be placed on the August primary ballot instead. 

Missourians welcome the chance to vote on Medicaid expansion earlier rather than later, especially given the state of healthcare in our state throughout this pandemic. The timeline is shortened and organizers will have to rally together to make sure we can educate and turn out voters at this earlier date. But healthcare has never been more at the front of Missourians’ minds, so there is no time like the present.

Parson’s address cited budget concerns regarding Medicaid expansion, and this is the only argument the opposition can come up with against expanding Medicaid. So let’s just address the claims that Missouri “can’t afford” to expand Medicaid:

• Currently, Missouri covers 35% of the cost of its Medicaid program, while the federal government covers 65%. Expanding Medicaid will shift that cost-sharing to 10% Missouri, 90% federal government. And no, contrary to faulty messaging that is floating in the ether, this percentage does not fade over time. The government covers 90% of the expanded Medicaid program in perpetuity. 
• Parson claims that Missouri’s shift to cover 10% of the expanded Medicaid program will cost the state too much money, and that Missouri already pays too much in Medicaid program expenses. A Washington University study actually found that with this shift in cost-sharing, added to the savings other departments will see as a result of improved health outcomes, the state actually comes out ahead. 
• The WashU study also highlights that Missouri taxpayers currently send $64.1 billion in taxes to the federal government, and are leaving more than $1 billion on the table by not accepting those federal funds back into our state to expand Medicaid and reap the benefits to our healthcare systems, our people’s health, and our economy.
• There are plenty of long-term benefits to our state having increased access to healthcare, including: a healthier population, a healthier workforce, better access to healthcare for kids, added jobs in our healthcare systems, better access to mental health care, and many more. I’m reminded of the saying, “A rising tide lifts all boats.”

In addition to these counterpoints to fiscal concerns, expanding Medicaid will bring healthcare to an estimated 230,000 Missourians who are uninsured. These are your service industry workers, many healthcare workers who work part-time, college students whose parents don’t have insurance, fast food workers, hair stylists – workers who work hard to provide for themselves and their families. But many of these jobs don’t offer health insurance, and these workers don’t make enough to afford private insurance, but currently make too much to qualify for Medicaid under the current eligibility requirements – no more than 21% of the Federal Poverty Level (FPL) for non-disabled adults, or around $380 per month for a family of 3 (if you are a childless, non-disabled adult, you don’t currently qualify for Medicaid in MO). Expansion opens it up to childless, non-disabled adults, and raises the income limit to 138% of the FPL, or about $30,000 per year for a family of 3 and up to $18,000 per year for a childless, non-disabled adult. 

Digging into the details is tedious, but it also spells out the simple logic and fairness of expanding Medicaid. Thirty-six other states have expanded Medicaid and none have undone that decision. It’s a nonpartisan issue – voters, community leaders, and healthcare professionals from all across the ideological spectrum have acknowledged it as the right thing for our people, our hospitals, and our budget. 

One of the best ways we can make sure to spread the word about why Amendment 2 must pass on August 4th is by engaging our social networks of friends and family. I can tell you from my experience gathering signatures that as soon as people learn about how hard it currently is to qualify for Medicaid in our state, and realize who will qualify for Medicaid after expansion, that fact alone is enough to get folks on board. 

Another way to help make sure Amendment 2 passes is to get involved in voter registration efforts and volunteer with the campaign to phone bank and text bank to get out the vote.

Especially in these times, now more than ever, we need to expand Medicaid, and if we work hard, we the voters can do the right thing and make it happen.