Missouri voters approve Medicaid expansion, after push from bishops

CNA Staff, Aug 5, 2020 / 14:13 pm

Voters in Missouri approved Tuesday an expansion of Medicaid to more than 230,000 low-income people in the state, a move which drew praise from the state's four Catholic bishops.

"The vote to expand the Medicaid program will provide greater access to health insurance coverage for the working poor. We are hopeful that the expansion of this important program will improve health outcomes for those with unmet healthcare needs as well as help Missouri's hospitals keep their doors open, especially in rural parts of the state," the bishops of Missouri said in an Aug. 5 statement.

The Aug. 4 decision will mean adults between the ages of 19 and 65 whose income is at or below 138% of the federal poverty level will be covered by the federally subsidized health program, the St. Louis Post-Dispatch reported.

The federal government will pay for 90% of the cost of the expansion, with 10% coming from the state.

An analysis of the expansion by Washington University in St. Louis found that although the move would cost the state an additional $118 million a year, that cost would be offset by savings elsewhere and an increase in tax revenue because of a boost in spending on health care services, leading to an estimated $39 million a year in net savings.

Missouri joins 36 other states and the District of Columbia in expanding Medicaid, a right given to states under the Affordable Care Act. Medicaid is known by different names in different states; in Missouri it is known as MO Healthnet.

The Missouri Catholic Conference had during October 2019 thrown its support behind Amendment 2, the ballot measure to approve the expansion. The measure ended up passing with 53% approval.

The bishops cited paragraph 2288 of the Catechism of the Catholic Church, which states that concern for the health of its citizens requires society to "help in the attainment of living conditions that help citizens grow and reach maturity: food and clothing, housing, health care, basic education, employment, and social assistance."

The bishops praised the MO HealthNet program for its health coverage to Missouri's most vulnerable citizens, including the elderly, the disabled, pregnant women, and children. Nearly 10% of Missouri's population, or about half a million people, were uninsured in 2018.

"In our Catholic ministries throughout the state, however, we find that there are still many Missouri citizens who lack access to affordable healthcare coverage that is so necessary for human flourishing. We, therefore, support expanding the program to cover low-income workers, since doing so will help lead to better health outcomes for them and enhance their ability to continue working to support themselves and their families."

The bishops acknowledged that some pro-life voters in the state had expressed concern about the expansion of Medicaid because of the possibility of federal funds being used to fund abortions if the Hyde Amendment- the federal prohibition on Medicaid funds for abortions- is overturned.

The risk that the Hyde Amendment will be overturned is small, the bishops have said, even though presumptive Democratic presidential nominee Joe Biden has signaled that he no longer supports Hyde Amendments.

Still, the bishops pledged to continue to advocate that the Hyde Amendment remain a part of federal law.

"We want to make it clear that our support for human life at all stages is unwavering. Indeed, helping those in need obtain health care is part of being pro-life and part of our call from Christ to see Him in the face of those less fortunate," the bishops said.

"We believe providing low-income working mothers with health insurance coverage that remains in place after they deliver will reduce the demand for abortions."

The Medicaid expansion vote in Missouri was starkly split between urban and rural areas, with the metro areas of Kansas City, St. Louis, Springfield, and Columbia largely voting yes and the rest of the state, which is heavily rural, largely voting no.

Studies have found that expansions in other states, such as Washington, have resulted in reductions in uncompensated care costs for hospitals and clinics, which has helped stabilized struggling, rural hospitals, the St. Louis Post-Dispatch reported.