As election day approaches, it’s time for Missourians to vote on Medicaid expansion. At Mosaic, we are asking you to consider voting YES on Amendment 2. In short, it would provide health insurance coverage for about 230,000 of the poorest Missourians who are uninsured today, improve our state’s economy by adding an estimated 16,000 jobs, earn a higher federal match (90%/10%) than our current program (65%/35%), and would support our hospital and other rural hospitals. Currently rural hospitals (like ours) are providing millions of dollars in uncompensated care each year while roughly half are losing money and fighting for the right to continue to serve their communities. Since 2014, 10 rural hospitals have closed in Missouri.

One of the key goals of the Affordable Care Act (ACA) was to provide health insurance coverage for approximately 40 million uninsured Americans. To help finance that expansion in coverage, hospitals took payment cuts from the federal government. Of course, federal money comes from taxpayers in each state, including Missouri. In states that have expanded Medicaid (now 37), the cuts and coverage offset one another and help fund a system where nearly all Americans can access affordable preventive care and primary care when they need it. In states like Missouri that haven’t expanded Medicaid, the federal burden on taxpayers is the same, but the money from those cuts does not flow back into our state to provide coverage for individuals or payment to health care providers. When coverage is lacking, our uninsured often defer preventive health care services like cancer screenings. This leads to poorer health, greater expense and care that is delivered in emergency rooms rather than doctors’ offices.  Health care coverage shouldn’t be about which side of a state line you reside in. The working poor should be able to access preventive and primary care, and Missouri’s health care providers shouldn’t be at a disadvantage with their peers in neighboring states that have expanded.

Many opponents of Amendment 2 are concerned about the potential additional costs of expanded coverage at this uncertain time. Studies from Washington University in St. Louis and the research firm Health Management Associates both project a significant benefit to our state based on their study of previous expansion states like Arkansas, Indiana, Kentucky & Ohio. Over the past decade, 37 states (including several conservative midwestern states) have accepted an enhanced federal match and expanded Medicaid eligibility. None have switched back, and we believe that the benefits to Missouri would lead us in a similarly good direction.

As COVID-19 has moved through the state, we have seen the health and economic toll it has exacted. Health care is essential, and Medicaid coverage will help hardworking, low-income individuals access the care they need, when they need it. Amendment 2 is a good deal that has earned the endorsements of over 300 Missouri organizations, including business groups like the Missouri Chamber of Commerce, healthcare groups like the American Cancer Society - Cancer Action Network and faith groups like the Missouri Catholic Conference. There is a lot at stake. Please vote on Aug. 4 and help us say YES on Amendment 2.  

–– Nate Blackford,

President, Mosaic

Medical Center - Maryville

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