Supporters of Medicaid expansion urge state to act

Tuesday, April 28, 2015
Supporters with Empower Missouri gather Monday afternoon in Cape Girardeau to advocate for Medicaid expansion in Missouri. (SAMANTHA RINEHART)

While the end of the Missouri legislative session is just a few weeks away, local supporters of Medicaid expansion still are hopeful action could be taken.

An event Monday by Empower Missouri, which recently changed its name from the Missouri Association for Social Welfare, in Cape Girardeau gathered about a dozen people, many of whom said they plan to continue expansion efforts such as writing to state representatives.

The Southeast Missouri chapter of Empower Missouri has organized many events this year, such as neighborhood canvasses, to discuss the need to expand Medicaid coverage to help cover hundreds of thousands of Missourians who fall into the coverage gap -- meaning they earn too much to qualify for Medicaid but too little to qualify for subsidies assisting in the purchase of a plan on the insurance marketplace.

Chairman Walt Wildman said the local group was one of many to host such events across the state.

While the state is "in the final throes of this legislative session," Wildman said it was important supporters remain persistent in their efforts to get their message to the Missouri Capitol.

State legislators, particularly Republicans, have made clear they hold little interest in expansion without some type of reform and have called the issue a "non-starter" this year, despite interest from some Democratic lawmakers to move forward on the issue.

Concerns of fraud and the eventual tapering off of federal funds are among the key issues cited by those against the idea. Wildman said the same questions "keep popping up over and over again" a the cost of expansion. He encourages people to do their research on the matter.

Supporters gathered Monday went home with handouts containing information from the Missouri Budget Project, a not-for-profit public policy analysis organization, which claimed Medicaid expansion would save Missouri money if it expands Medicaid. This would largely come from additional funding from the federal government.

States that expand adult Medicaid eligibility to 138 percent of the poverty level -- about $27,000 annually for a family of three -- initially can receive full federal funding under the Affordable Care Act. The federal aid eventually will be reduced to a 90 percent share, with the states covering the remaining costs.

The Missouri Budget Project offers a few examples where that higher federal share could represent savings for the state. For instance, Missouri covers pregnant women with incomes below 138 percent of the federal poverty level through Medicaid, with the state covering 37 percent of the cost, the group says. With the expansion, 90 percent of the costs would be covered by the federal government, leaving the state responsible for the remaining 10 percent.

Missouri now provides Medicaid coverage only to adults with at least one dependent child, who earn no more than 19 percent of the federal poverty level. By those guidelines, an eligible, single parent of two could earn slightly more than $300 per month.

Groups such as Empower Missouri continue to push for the change to 138 percent of the federal poverty level. Wildman said it may be too late for any legislation seeking this change to be crafted, but that doesn't mean there are not remaining opportunities during the final weeks of session.

"The potential is in the next three weeks, someone could amend some legislation going through," he said.

The final day of Missouri's legislative session is May 15.

srinehart@semissourian.com

388-3641

Pertinent address:

Cape Girardeau, Mo.

Map of pertinent addresses

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