There are numerous economic reasons why the expansion of Medicaid would be positive for the residents of Missouri. I’ll share a few and end with 459.
Studies have identified benefits such as the creation of jobs and the tax benefit of Medicaid revenues. A 2013 study by the University of Missouri School of Medicine projects that in 2014 alone, the expansion would have created over 24,000 jobs; from 2014 to 2020 it would generate over $855 million in state and local tax revenues. If this study is anywhere close to being accurate, Medicaid expansion will pay for itself many times over.
Increased productivity is another benefit. According to the National Academy of Sciences’ Institute of Medicine, a large uninsured population is associated with an astonishing loss of economic productivity because of missed work. Uninsured employees are significantly less productive than insured workers because they cannot afford care that would prevent them from getting ill or help them recover from an illness or injury more quickly. Under the Medicaid expansion, 300,000 working uninsured Missouri taxpayers would be eligible for those services.
For states that accepted the expansion, the benefits began Jan. 1, 2014, with 100 percent of the cost paid by the federal government for the first three years. For Missouri that would have meant $2 billion in 2014 in other words, that $2 billion of Missouri taxpayer money that’s going to other states instead of staying here.
There are a couple of reasons many of our legislators are concerned about the viability of Medicaid expansion. First is their suspicion that after 2016, when the state gradually becomes responsible for up to 10 percent of the cost, the federal government will drastically increase the states’ portion of the cost. If this were to happen, however, Missouri can simply withdraw from the agreement at any time.
The second is that Missouri cannot afford the taxpayers’ 10 percent cost of the expansion after the federal government’s contribution is reduced to 90 percent. That 10 percent is estimated to be $100 million per year. I don’t know about you but it seems like a good deal to me to get $2 billion in exchange for $100 million. Think about your personal investments, would you keep working if you get $20 dollars for every $1 dollar you invest?
There is also a hidden tax for not implementing Medicaid expansion. Under the Affordable Care Act, Missouri will begin to lose almost $400 million a year in what are known as DSH (disproportionate share hospital) payments — federal funds that help hospitals and clinics cover the costs of caring for the uninsured. This is money that people with insurance — that is, taxpayers — will have to pay because those federal funds are being withdrawn and because someone has to pay for the uninsured and in many cases that cost shift will be placed on the insured thus increasing the cost of insurance for individuals and employers.
A tax is a tax. Medicaid expansion provides many more people with insurance, thus replacing the money to be withdrawn from hospitals. The replacement of the DSH revenue loss, the increased productivity predicted by the Institute of Medicine and with the increased revenue predicted by the University of Missouri study dwarf the 10 percent Missouri taxpayers will be responsible for after 2016.
Beyond the financial benefits of Medicaid expansion there are even better reasons to act. Recent studies, such as the Oregon Health Insurance Experiment and studies reported in the New England Journal of Medicine and the American Journal of Public Health, indicate that low-income women will forgo recommended lifesaving breast and cervical cancer screening; diabetics will forgo medications, and all low-income adults will face a greater likelihood of depression, catastrophic medical expenses and death.
Every year Medicaid expansion would cover an additional:
• 26,666,667 mammograms, or
• diabetes care for 461,148 individuals, or
• 21.5 million physician office visits for primary care
The lack of health care services that would have been provided under Medicaid expansion will result in an estimated 459 deaths in our state in 2014.
What’s the value of your health? What’s the cost of not expanding Medicaid in Missouri? I believe there are 459 families who will be able to answer both questions by the end of the year!
Tell Lawmakers We Can’t Afford To Lose Another $2 Billion In 2015 or another 459 Missourians!