Medicaid Expansion Set to Increase Eligibility for

The Medicaid expansion, if passed, will allow large numbers of parents and childless adults with low incomes and under the age of 65 join the ranks of Missouri's Medicaid program. While allowing these individuals to join Medicaid will certainly help many Missourians finally obtain health insurance, the expansion does very little to address many of the issues facing current Medicaid recipients and if not done carefully may create new ones. In 1965 when Medicaid originally passed it was designed to cover low income individuals that were either, children, pregnant women, the blind, the elderly, or individuals with disabilities. All vulnerable groups likely to have trouble obtaining adequate health care and for which we felt compelled to help by providing care. Now, with the rapid rise of health care costs, the number of vulnerable individuals has increased well beyond those groups identified in 1965.

As Missourians discuss adding these new individuals to Medicaid, it is critical we also consider how this expansion will affect those individuals for which Medicaid was originally created. Under the expansion, parents and childless adults would be eligible for Medicaid as long as their income is equal to or less than 133% of the Federal Poverty Level (FPL). However, this new eligibility level would not apply to individuals with a disability. An individual with a disability who, for example, might otherwise qualify as a childless adult would not qualify for the new increased eligibility levels if he or she indicates his or her disability when applying for Medicaid. Instead the individual would only be able to receive benefits under the current disabled category of Medicaid. This means the individual must have income equal to or less than 85% of the FPL to qualify for Medicaid. While an individual with a disability could choose not to disclose their disability, this can create issues because individuals with disabilities often receive specialized treatment or benefits to help them with their disability and not disclosing it would exclude them from this treatment.

If Missouri Legislators decide to expand Medicaid, they should strive to create a program that is both effective and flexible in order to make sure all Medicaid beneficiaries have their needs met.