This article first appeared in the St. Louis Beacon, Jan. 16, 2013 - As nurse practitioner Judith Gallagher related story after story of families or individuals who had no health insurance or had lost it – and couldn’t qualify for Medicaid in Missouri – she emphasized one common fact about each case.
“These are not people trying to get free rides from hardworking taxpayers,” Gallagher said, her voice rising. “These ARE hardworking taxpayers.”
Gallagher was among a parade of speakers Wednesday addressing more than 100 people at the Kirkwood Baptist Church as part of a statewide kickoff of a campaign to persuade the Republican-dominated General Assembly to support the expansion of Medicaid in Missouri, as sought by the federal Affordable Care Act.
The kickoff comes as Gov. Jay Nixon, a Democrat, is ramping up his campaign to expand Medicaid with another round of stops throughout the state to promote the idea. Nixon plans to include the expansion in his proposed budget.
So far, Republican legislative leaders – several of whom hail from the St. Louis area – are cool to the idea, even though the federal government would pick up the entire tab for the first three years of the expansion. After that, the federal share drops gradually to 90 percent.
State House Speaker Tim Jones, R-Eureka, is among the opponents who cite fiscal as well as philosophical reasons. They question whether the federal government can afford the cost while also opposing government getting more involved in health care.
Nationally, Republican governors appear divided. Although many have announced plans to reject Medicaid expansion, at least four – including Arizona’s Jan Brewer – now say they will participate, largely because of the federal money.
At Wednesday’s gathering, pro-Medicaid speakers contended that legislative opponents don’t understand the current landscape. Some uninsured speakers told of being unable to obtain insurance on their own because of health issues, such as being a cancer survivor.
Gallagher’s point was that an increasing number of Missouri workers have employers who don’t provide health insurance, even for full-time employees. Many workers can’t afford to purchase the coverage on their own at market rates, she said.
Megan Burke, a policy analyst at Paraquad, noted that Missouri’s current eligibility requirements are so strict that a family of three earning $3,500 a year doesn’t quality.
The Missouri Hospital Association is seeking to increase the pressure on legislators, with some rural hospitals predicting they’ll close if the expansion doesn’t happen.
Sidney Watson, a law professor at St. Louis University, told Wednesday’s crowd that Missouri hospitals expect to soon lose $400 million a year in federal payments for caring for people who are uninsured. The federal payments will stop because most of the uninsured are expected to qualify for Medicaid coverage – if Missouri participates in the expansion.
Watson said the state also will save $348 million a year because it no longer would have to pay for its share of the costs for hospital treatment of the uninsured.
Rabbi Susan Talve told the audience that it was time for backers of Medicaid expansion to become more visible and more vocal. Her message to the legislators: “We are many, and we mean business.”
