There’s a lot of discussion about Medicaid expansion in Missouri. Many Missouri legislators have stated that they do not support Medicaid expansion even though the Federal Government would pick up the full cost at first and then drop to paying 90 percent in coming years. The state would spend around $400 million over 10 years to get $8.3 billion from the Federal Government.
$400 million is a lot of money for our struggling state to come up with but there is a business case to supporting the expansion and the Missouri Chamber of Commerce is endorsing the expansion. You would not necessarily think that an organization focused on business would get into the arena on this issue but they have and that’s because it’s a business decision.
The truth is businesses are already paying for health care, indirectly but substantially, as insurers shift costs. The cost of uncompensated care is offset by businesses that provide health insurance for employees. If the expansion is approved there will be 300,000 more Missourian’s with health coverage and uncompensated care will decrease.
The expansion will also protect jobs. More people with coverage means more people getting care, more work for doctors, nurses and other health care workers and the location of care will be more appropriate. Coverage means people can access care in a primary care office as opposed to the last resort of an emergency room which will decrease cost. The Missouri Hospital Association recently released a study that said the expansion would create 24,008 new jobs in the state and that the payroll tax and spin-off revenue would offset the $400 million price tag the state has to pay.
There’s another important factor at play that deals with jobs. Hospitals currently get federal money to offset uncompensated care. That money is going away over the next few years and the Medicaid expansion would help to off set that loss. Without the expansion there is a chance that some hospitals in Missouri would be forced to close.