I realize that in many quarters there is a feeling that all federal spending, even for vital human services, must be cut. However, if we can put that aside for the moment and look at the reality of life in Missouri, I would offer these considerations.
“The poor you will always have with you and you can help them when you will.” Mark 14:7.
This is not a prediction indicating: help the poor whenever you get around to it. Rather it is a promise that they are not going away, but when we help them we help ourselves. Additionally it is saying, help the poor who are always with us, because not doing so will cost us plenty in this world and dearly in eternity.
“Whatever you did for the least of your sisters and brothers, you did to me.” Matthew 25:45.
There would be no cost to Missourians expanding Medicaid for the first two years of the Affordable Care Act, because all new Medicaid costs would be paid by the federal government. After two years, Missourians will have to pay 10 percent of the cost.
Without Medicaid expansion there is a great cost to Missourians, because sick people without insurance will still get medical assistance. They will get it from the most expensive and least effective place, their nearest emergency room.
Emergency medical care has astronomical costs and only the shortest of short-term benefits. By law, emergency care must be given to people without money or insurance, regardless of their ability to pay. Since hospitals still need to be paid, Missourians who have insurance will be charged more by the hospitals to meet their deficit and stay in business. If the demand is great than the market will bear, many small rural hospitals will close, according to the Missouri Hospital Association. Many jobs will be lost, and tax revenue will plummet.
Medicaid will cost Missourians because our federal tax dollars will be used to pay for Medicaid in the other states, most of whom have signed up for the expanded Medicaid program.
Sadly, there will be an even higher cost for people of our state. Sickness, viruses and bacteria are not respecters of people's insurance coverage or financial status. Many low-wage jobs done by uninsured people are jobs that are close-up and personal like food service, child care and health-care positions in hospitals and nursing homes.
Poor people who are sick still go to work because their paycheck is a matter of life or death. Without it, they cannot pay for housing, food, utilities, transportation and clothing. They will spread their contagion to others, including the people whom they are paid to serve – those who use restaurants, child-care agencies, hospitals and nursing homes.
The cost of compromised health for all Missourians could be an epidemic and consequently could far outweigh purely economic factors. Sick days and absenteeism are extremely expensive at school and in the workplace. And none of this considers the emotional and stress costs that are incalculable.
The words on the great seal of state of Missouri are worth noting. The English translation of the Latin is “The welfare of the people is the highest law.” When I testified before a committee in Jefferson City recently, that seal was displayed prominently. I trust that it will be lived out in the decisions of our public servants and in the hearts of all Missourians.
The Rev. Gerald J. Kleba is pastor of St. Cronan's Parish, St. Louis.
