Medicaid expansion on the ballot Tuesday

Expanding access to Medicaid will appear on Tuesday's ballot as Constitutional Amendment 2.

Medicaid is the federal health program that covers those who meet certain income, age or disability requirements.

Missouri adults with dependent children are only eligible currently if their household income doesn't exceed 22% of the federal poverty level, or about $3,792 annually for a two-person household. However, there's also access for children whose parents make more money. Missouri Treasurer Scott Fitzpatrick told the Southeast Missourian that children whose parents or guardians make less than 300% of the poverty level can already receive access to Medicaid.

The Affordable Care Act allowed for the expansion of Medicaid for those with incomes up to 138% of the federal poverty level, or about $23,791 for a two-person household. Missouri is reimbursed by the federal government for about 65% of its Medicaid costs. The expansion would raise that reimbursement to 90% -- at least initially, with the state on the hook for the balance.

Proponents say this is necessary to provide coverage to those most in need. Hospitals have championed Medicaid expansion, and the Missouri Chamber of Commerce endorsed it, calling it "a pro-jobs measure that will help fuel economic growth."

Supporters say Missouri is missing out on federal dollars that should be coming to the state and the Show Me State is at a competitive disadvantage compared to states where Medicaid expansion has been approved.

Opponents say the state can't afford this expansion of government. While the reimbursement percentage would increase, so would the number of eligible people and therefore overall costs to state government -- some say as much as $200 million per year. These individuals say cuts would have to be made in other areas, with education the most likely to be cut.

Some 37 states have approved Medicaid expansion, but Fitzpatrick said some now regret the decision. Meanwhile, only Texas and Alabama have lower Medicaid-eligibility caps.

This is a big issue for the state that will have a lasting impact. We encourage readers to educate themselves and make their own decisision before voting Tuesday.