Advocates make pitch in Cape neighborhoods for Medicaid expansion

Advocates for Missouri Medicaid expansion took to the streets Saturday morning to spread awareness of the situation and offer ways for residents to encourage change among their local lawmakers.

"[We are] asking [legislators] to close the coverage gap so the other hundreds of thousands of Missourians can be covered and have access to medical care as well," said Cheryl Garrett, president of the local Cape Girardeau chapter of Empower Missouri. "We're not going to do this for one day. We're going to keep this on for three or four days to make sure we get the majority of Cape Girardeau and Jackson."

Members of the Missouri Medicaid Coalition and fellow supporters participated in 23 neighborhood canvasses across the state, including Cape Girardeau and the Bootheel.

In the wake of the enactment of the Affordable Car Act, also known as Obamacare, more than two dozen states offer expanded Medicaid programs. But the Republican-led Missouri Legislature has opted to not expand the program.

Missouri's Democratic governor, Jay Nixon, has pushed for Medicaid expansion since 2012. So far, the effort has been unsuccessful, but he is hoping for change this year.

"We're going to continue to have problems in the heath-care area if we continue to spend $2 billion in taxpayers' dollars to Washington, D.C., and not get that money back to improve access to quality care," Nixon said to reporters last week during a visit to Cape Girardeau County.

States with expanded Medicaid offer a variety of options for adults who are in "the gap" of health-care coverage. About 300,000 uninsured Missourians fall in that gap -- earning too much to qualify for Missouri's Medicaid program, but earning too little to qualify for subsidies that would enable them to buy a plan on the insurance marketplace, according to information from the Missouri Medicaid Coalition. Expanding Medicaid to 138 percent of the federal poverty level would provide more-affordable access to health insurance to Missourians in the gap, according to the coalition.

Some lawmakers object to the Medicaid expansion because they don't expect the federal government to fund it for the long-term.

Garrett said she and her daughter have struggled with getting health insurance. After Garrett lost her job in 2008, she went for six years without it.

"I was basically living on a wing and prayer that nothing catastrophic would happen to me, because if it did, I didn't know how it was going to be paid," she said.

Since then, Garrett has signed up for insurance through the Affordable Care Act plan's marketplace exchange. Missouri enrollees can choose from seven insurance issuers, including several "in-network providers" at area hospitals. By using an in-network provider versus an out-of-network provider, those enrolled generally will have more of their medical bills covered by insurance. The deadline to enroll in coverage this year is Feb. 15.

Garrett chose UnitedHealthcare insurance for her coverage needs.

After canvassing her neighborhood Saturday, Garrett said many people responded positively to the pamphlets she distributed but were unfamiliar with Medicaid expansion issue in Missouri.

"People were asking me about it, because you have some who really don't understand the need for the Medicaid expansion. Then you have those who did understand, but they didn't know who to contact," Garrett said.

Main concerns for health-care industry leaders are financial concessions hospitals began to make when the health-care law was enacted, according to previous reports. Providers nationwide collectively started taking billions of dollars less in federal reimbursements on the idea the Affordable Care Act would result in less bad debt and fewer uninsured patients, thus offsetting the loss in the reimbursements.

This is an issue that affects everyone, Garrett said, and it is her goal within Empower Missouri to ensure everyone is aware of the issue.

"[Some people], if the problem is not affecting them, then they don't care," Garrett said. "And that's not the way it should be. This is something that impacts everybody."

smaue@semissourian.com

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