A yes vote for Amendment 2 on August 4, 2020 would extend benefits to more than 230,000 hardworking Missourians, many of whom make up the state’s essential workforce. Missouri Medicaid expansion will deliver health care coverage to individuals earning up to $18,000 per year, and $30,000 for a family of three.

This access is critical to Black Missourians, who have been disproportionately impacted by the coronavirus. Nationally, Black people are infected at a rate 2.4 times higher than Whites and 2.2 times higher than Latinxs and Asians. To date, more than 26,000 Black people have died from COVID-19. This number is expected to increase as new cases continue to surge. According to Healthcare for Missouri, an expanded version of Medicaid would cover 36,000 more Black Missourians.

Even after COVID-19 ripped the veil off health care disparities among people of color, the current administration remains motivated to repeal the Affordable Care Act (ACA), which included 203,000 Missouri enrollees in 2020. If successful, this could mean many more uninsured Missourians with no access to health care.

This makes a yes vote on Amendment 2 even more imperative. Additionally, a yes vote on Amendment 2 will provide health care to [working] Missourians whose employers do not offer health care, or who have lost their jobs and face economic uncertainty. Prior to the pandemic, Missouri’s uninsured rate was 9.4%.  With pandemic-related job losses, The Urban Institute estimates the uninsured rolls will increase by more than 40% in non-expansion states, compared with less than a quarter in expansion states. If a bright red state like Oklahoma can pass Medicaid expansion, certainly Missouri can become the 38th state to deliver health care to individuals who need it the most.

This includes older adults. An estimated 18,000 near-retirees would also benefit from Medicaid expansion. These are the individuals not old enough to qualify for Medicare, and whose jobs either do not provide health insurance, or the cost for coverage is too expensive. For older adults with Medicare, many of their caregivers and family members fall into the coverage gap. Medicaid expansion would make them among the newly enrolled. Amendment 2 also covers veterans who do not have Veteran’s Association (VA) benefits.

The state also benefits. According to a study commissioned by the Missouri Foundation for Health (MFH) and conducted by Regional Economic Models, Inc., (REMI), it is projected Amendment 2 would bring more than 16,000 new jobs to the state per year, boost economic output by $2.5 billion, and increase personal income in the state by $1.1 billion, or more than $500 per household. REMI also projects nine in10 of the new jobs will pay more than $15 per hour.

Missouri also benefits by bringing home its tax dollars, dollars that have bypassed this state and benefited expansion states. The federal government will pay 90% of the costs, leaving Missouri to cover the remaining 10%. To put this into perspective, Missouri covers 35% of MO HealthNet, the state’s current Medicaid program. Economists say tax revenues generated by economic growth and new job growth will help offset Missouri’s 10% contribution to Medicaid expansion, positioning the state to realize some of the same economic gains as other expansion states.

If Amendment 2 does not pass, Missouri’s tax dollars will benefit the other 37 states that expanded Medicaid. It could also foster more rural hospital closures. A recent report from the Chartis Center for Rural Health says that 2019 was the worst year for rural hospitals this decade, with 19 rural hospitals shutting their doors. The report, published in February 2020, also says nearly one in every four open rural hospitals is showing early warning signs that closure may be imminent soon.  In Missouri, 15 hospitals have closed since 2014, and 10 were in rural communities.

According to Chartis, rural hospitals in expansion states are 62% less likely to close. However, non-expansion states like Texas, Tennessee, Georgia, Alabama, and Missouri experienced the most rural hospital closures over the last decade. (Oklahoma was also included in the list but managed to narrowly eke out enough votes to expand Medicaid on July 1.)

Missouri, it is time to expand Medicaid. Health care has for too long been a privilege for some, and a literal death nail for others. This is one thing we can do, now, to make life less stressful for so many deserving individuals – the vast majority of whom are working adults.

Keeping those dollars home, with a yes vote, means securing employment for front-line health workers and keeping rural hospitals open. Expanding Medicaid is not a partisan issue. Access to quality health care is a basic right, one that too often makes the difference between life and death for the underserved and marginalized. We have the power to make life just a bit better for those who have been left behind. Quite frankly, some of these individuals are our family members.

On August 4, 2020, let’s stand unified on this issue and work collectively to pass Medicaid expansion in Missouri. Please vote yes on Amendment 2.

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