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By Cindy O’Laughlin
In January, I wrote that one of the most important issues in Missouri politics this year is Medicaid Expansion. Currently, Medicaid consumes almost 40% of our state’s annual budget. The reality is that we already pay more for Medicaid than anything else in our budget, and we could potentially have to cover 200,000 more people if Missourians vote to expand the program.
Why would we expand a program to cover working, able bodied adults that was never intended to cover them? Currently, we “short pay” nursing homes for Medicaid residents. This results in the nursing homes losing money every single day on these residents. Adding a whole new set of Medicaid claimants will make this problem much worse. Where will the money come from? Most likely, it will come from schools as that is our next largest state budget expenditure. Do you want to reduce funding to schools in order to place able bodied adults on Medicaid?
I have written about my concerns in the past. The federal government will potentially pay 90% of the cost for each participant, but in my opinion it is a typical government “hook.” States agree to something because their share is only a small percent initially, but then after getting thousands of people on the benefit the federal government starts cutting back their share and the state’s cost skyrockets. We must first get control of this explosive expense before even considering an expansion. This is why the legislature has refused expansion.
In the concrete business, we would never purchase a new piece of equipment, or hire a new employee if we didn’t know for a fact that we could pay for it. We also wouldn’t take on a project if we knew we couldn’t complete it to the highest standard. In government, we take on more than we can handle without thinking about the repercussions, and we then figure out how to pay for it later, which often costs the taxpayers.
Don’t rule out a tax increase if Amendment 2 passes. Medicaid Expansion will place an enormous burden on our state’s budget, and there’s not a lot of good ways to fix that. In Northeast Missouri, we had rural hospitals with some severe financial pressure, even before Coronavirus. Medicaid Expansion will not fix their problems. New York and Ohio are facing major budget shortfalls because of their Medicaid Expansion. According to Real Clear Health, California currently has a $54 billion deficit, their largest ever, and is considering cuts to their Medicaid program. States who have expanded were facing massive budget cuts before the pandemic. Why would we put this added stress on our state’s budget when we can’t make ends meet right now?
In the last few years many states, including Kansas, have had Medicaid Expansion initiatives before their state that have been rejected by their legislatures. In Missouri, legislators have not passed Medicaid Expansion because it is a bad idea. Supporters have now put it on the ballot, and I cannot begin to emphasize enough how badly we need to vote “no” on Amendment 2 at the ballot box.
As always I appreciate hearing your perspective on this and other issues presented in my weekly column. Please feel free to contact me in Jefferson City at (573) 751-7985. You may also email me at [email protected]
Also, if you want to read further about the problems with Medicad Expansion, these are links to two great articles.