All posts tagged Medicaid expansion in Missouri

Missouri, And America, Apparently Need Some European Socialism

Everywhere you look, Republicans fear what they often call “European socialism.”

Here in Missouri, right-wingers, who dominate the legislature, are cutting taxes mostly for corporations and wealthy folks. And then they are asking voters to approve a regressive sales tax. They refuse to expand Medicaid (socialized medicine!) and give health insurance to folks who need it. Meanwhile, look at this:

When it comes to measuring health systems, Missouri is 44th among the states and the District of Columbia in terms of “access and affordability, prevention and treatment, potentially avoidable hospital use and healthy lives.” Get that? This state is almost at the bottom. The only states below us are Georgia, Kentucky, Arkansas, Alabama, Louisiana, Oklahoma, and Mississippi. Think about that. Missouri isn’t that much better than Mississippi, in terms of our health system. Yikes. And people are dying because of it. The Commonwealth Fund estimates as many as “86,000 deaths a year would be avoided if some states improved their health systems.” Yikes, again. (For an “estimated impact of improving performance” for Missouri, go here.)

Mittens Romney tried to use socialism to scare Americans in 2012, when he told us that President Obama was “taking us down a path towards Europe.” Would that be so bad? some might ask, especially some in Missouri who don’t have health insurance. To answer that question, I will end with an extensive quote from a recent column by Robert Reich, in which he explained how bad the Canadians and Europeans have it:

Most of them get free health care and subsidized child care. And if they lose their jobs, they get far more generous unemployment benefits than we do. (In fact, right now 75 percent of jobless Americans lack any unemployment benefits.)

If you think we make up for it by working less and getting paid more on an hourly basis, think again. There, at least three weekspaid vacation as the norm, along with paid sick leave, and paid parental leave.

We’re working an average of 4.6 percent more hours more than the typical Canadian worker, 21 percent more than the typical French worker, and a whopping 28 percent more than your typical German worker, according to data compiled by New York Times columnist Nicholas Kristof.

But at least Americans are more satisfied, aren’t we? Not really. According to opinion surveys and interviews, Canadians and Northern Europeans are.

They also live longer, their rate of infant mortality is lower, and women in these countries are far less likely to die as result of complications in pregnancy or childbirth.

But at least we’re the land of more equal opportunity, right? Wrong. Their poor kids have a better chance of getting ahead. While 42 percent of American kids born into poor families remain poor through their adult lives, only 30 percent of Britain’s poor kids remain impoverished – and even smaller percentages in other rich countries.

With results like that, it is too bad that President Obama isn’t “taking us down a path towards Europe.” I know some folks in Missouri who wish he would.

by R. Duane Graham on May 30, 2014  •  Permalink
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Posted by R. Duane Graham on May 30, 2014

https://duanegraham.wordpress.com/2014/05/30/missouri-and-america-apparently-need-some-european-socialism/

Would Jesus Expand Medicaid In Missouri? I’ll Let Him Tell You (UPDATED)

“Missouri’s low income and vulnerable citizens will have access to excellent health care in order to maximize their quality of life and independence.”

—The “vision” statement of Missouri’s Medicaid program, MO HealthNet Division

I swear the following story is in your Bible:

On one occasion an expert in the law stood up to test Jesus. “Teacher,” he asked, “what must I do to inherit eternal life?”

“What is written in the Law?” he replied. “How do you read it?”

He answered, “‘Love the Lord your God with all your heart and with all your soul and with all your strength and with all your mind; and, ‘Love your neighbor as yourself.’”

 “You have answered correctly,” Jesus replied. “Do this and you will live.”

But the expert in the law wanted to justify himself, so he asked Jesus, “And who is my neighbor?”

In reply Jesus said, “A man was going down from Jefferson City to Joplin, when he found out his job was being outsourced to China. All in one moment he lost his income and along with it his health insurance, which he needed because his wife had a serious health condition. A Religious Right preacher happened to be going down the same road on his way to vote for a Republican, and when he saw the uninsured man on the side of the road in much distress, he passed by on the other side. So too, a Teapartier, when he came to the place and saw him, passed by on the other side, as he was also on his way to vote for a Republican.

But a Samaritan, a man who believed in the social safety net, came by where the man was, and when he saw him, he took pity on him. He went to him and told him not to worry. He told him that he was voting for someone who would make sure that he and his wife had affordable health insurance, whether he had a job or not. He told him that he was voting for someone who would make sure his unemployment benefits wouldn’t dry up before he had a fair chance to get another job. Then he put the man in his car, registered him to vote, and brought him to the polling place. 

“Which of these three do you think was a neighbor to the man who lost his job and his health insurance?”

The expert in the law replied, “The one who had mercy on him.”

Jesus told him, “Go and do likewise.”

Here in Missouri, Republicans have blocked the expansion of Medicaid, which would have been fully paid for by the federal government for the next three years. After that the state would eventually pay no more than 10% of the cost, as the program is fully phased in by 2020. The point is that it wouldn’t cost the state a dime—not a dime—until 2017, and even then it wouldn’t cost much. It is estimated that in 2015 Missouri would receive $1.7 billion to help expand the program and bring insurance to more people who can’t now afford it, which could be somewhere between 260,000 and 310,000 Missourians.

Here is a look at just who would benefit if the program were expanded today, again at no cost to the state:

medicaid expansion in missouri

Right now, without Medicaid expansion in this Jesus-loving state, if you are a parent or parents in a family of four and can’t afford private health insurance but have an income over $4,475 a year (19% of the 2013 Federal Poverty Level), you aren’t eligible for Medicaid. Yes, you read that right. If you preside over a family of four and make over $4,475 a year (a bleeping year!) but don’t make enough to buy health insurance, as a parent you are not eligible for Medicaid in Missouri. If you’re wondering, that cutoff for eligibility is the lowest allowed under the federal law that initially established the national program.

Under expansion, your family situation wouldn’t matter. Neither would your disability status. If you were parenting a family of four and earned up to $31,322 a year (based on 133% of the federal poverty level for 2013), you would be eligible for help if you didn’t otherwise have health insurance. If you were a single adult, you could earn up to $15,282 a year and qualify for health insurance under Medicaid. And as a comprehensive study indicated, the expansion is not only good for the entire state (it would actually bring in more dough to the treasury), but it is especially good for folks who live in places like where I live here in the southwest corner:

medicaid expansion map

See that? Just in our part of the state more than 60,000 of our New Testament-toting neighbors would get health insurance. Hallelujah!

Except that here in this Jesus-loving town of Joplin, here in God-fearing Southwest Missouri, lives the Majority Floor Leader of the Missouri Senate, Ron Richard. I don’t know if he loves Jesus or not, but I do know he is opposed to Medicaid expansion and voted against it last week, as did every single Republican in the Senate. Here are the duties of his august position:

The Majority Floor Leader sets the schedule of bills up for consideration by the full chamber, the time spent on floor debate for legislation, and the meeting times and dates of the Missouri Senate, among other duties.

As you can see, Ron Richard is a powerful man. He can change the dynamics of the debate on the expansion of Medicaid in Missouri in less time than it would take a House Republican to say, “Impeach the socialist in the White’s House!” Below are ways to contact him:

Jefferson City Office, Pattie: 573-751-2173

Joplin Office, Gwen: 417-623-0022

Or send him a message:

http://www.senate.mo.gov/D32WebApps/Contact.aspx
http://ronrichardmosenate.com/contact.php

You can use one or all of the above methods in order to a) ask him if he loves Jesus, or b) ask him if he wants to treat his fellow Missourians like a good neighbor, or c) do what I did and send him a message like this:

ron richard websiteI respectfully ask that Sen. Richard lead the charge on expanding Medicaid in Missouri and bring some relief to hundreds of thousands of Missourians who need health insurance. We are leaving billions of dollars on the table, money that is needed here in our state to care for our own. Do the right thing, please.

_________________________________

UPDATE: Here is the email response I received from Sen. Richard. Based on this response, it wouldn’t hurt for all of you who are interested in this issue to let him know where you stand:

Thank you for your email. This was brought up on the Senate Floor for debate. This was just the first discussion on the floor and I believe there will be a lot more before we have a chance to vote on the bill. I will keep your thoughts and comments in mind as this bill becomes perfected and we vote on the measure.

Please let me know if you have any further questions or concerns.

Sincerely,

Ron Richard
Senator District 32

by R. Duane Graham on February 12, 2014  •  Permalink
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Posted by R. Duane Graham on February 12, 2014

https://duanegraham.wordpress.com/2014/02/12/would-jesus-expand-medicaid-in-missouri-ill-let-him-tell-you/

Missouri Medicaid Expansion: A Matter Of Life And Death

Missouri Governor Jay Nixon was here in Joplin on Wednesday.

Susan Redden of the Joplin Globe reported that Nixon was in town “to assert that Medicaid expansion would be a good business decision for the state.” From the story:

With officials of area hospitals and health care providers standing behind him, Nixon told a Joplin crowd that rejecting the Medicaid expansion available under the Affordable Care Act would send tax dollars collected in Missouri to other states where the coverage has been expanded.

“The question is narrow: Will we bring back those federal tax dollars to help the state or not?” the governor said in a presentation at the Robert W. Plaster School of Business at Missouri Southern State University. “If we don’t, other states will get the help, and we’ll pay the bill.”

The article notes that some 300,000 Missourians will benefit from the expansion of Medicaid, and in the words of Governor Nixon,

the people it will help are working folks who otherwise are going to end up in the emergency room.

Naturally, since the expansion will help “working folks,” many Republicans are against it, including leadership in our right-wing-dominated legislature. But the Missouri Chamber of Commerce and some local chambers, but not yet including Joplin, are on board because they recognize the foolishness of rejecting the expansion, just to spit in the eye of Barack Obama.

Expanding Medicaid happens to be good for business and employment:

Nixon cited a study by the University of Missouri suggesting that the additional funding for health care would create 24,000 new jobs in Missouri the first full year of the expansion. And, he said, states that don’t expand coverage could be put at a competitive disadvantage when small businesses are looking to add jobs, which often start on the lower end of the wage scale.

“If businesses are paying the same wage, and workers are getting health coverage in one state and not another, it could make a difference,” he said.

Medicaid expansion is projected to bring back to the state $1.8 billion in the first full year of coverage, and $5.7 billion over three years, Nixon said. “If we take a pass, Missouri residents pay that money in taxes, but it goes to other states,” he said.

As most of us know, the Supreme Court, in upholding the constitutionality of the Affordable Care Act, ruled that the provisions in the law that required states to expand Medicaid coverage to folks earning below 138 percent of the federal poverty level went too far. The Court’s decision allowed states to opt out of the expansion, even while staying in the Medicaid program.

Some Republicans claim our state can’t afford to expand Medicaid. But the entire cost of the expansion is covered by the federal government from 2014 through 2016. Then, until 2020 the states have to cover 5% of the annual cost, and after 2020, the states have to cover 10%. And that’s it.  Providing health insurance to 300,000 working folks in Missouri is a damn good deal.

And it’s a good deal for hospitals and other health care providers, who clearly recognize the foolishness of keeping poor people from getting health insurance. Those poor folks often seek care—expensive care—at emergency rooms, and much of that care—mandated by EMTALA—is uncompensated.

The federal government, through Disproportionate Share Hospital allotments, provides support to hospitals (“safety-net hospitals“) that treat the uninsured who can’t pay. In 2011, that support amounted to $11.3 billion, a little more than one-fourth of the estimated cost ($41.1 billion) to hospitals for providing care to those who can’t afford it.

The Affordable Care Act, because its purpose was to insure people and reduce uncompensated care, lowers federal payments to hospitals that treat those who can’t pay. But because the Supreme Court made the expansion voluntary and because many Republican governors and legislatures hate Obama and ObamaCare, the states who opt out are burdening the hospitals in their states with extra costs.

That’s why here in Joplin Governor Nixon met with local hospital leaders, who have given him their blessing. One of those leaders, Paula Baker, president of Freeman Health System, said,

He didn’t need to sell us on it.

But beyond the finances of the Medicaid expansion, there is the human element. Consider this from The Incidental Economist, a blog dedicated to studying America’s health care system:

First of all, Medicaid is good for health. Let’s start with a simple truth: having health insurance is better than not having health insurance. Not only is health insurance good for health, but it actually saves lives. Medicaid is, of course, health insurance. Therefore, it comes as no surprise that studies show Medicaid improves health. Now some people have garnered a lot of attention by claiming that Medicaid actually hurts people. They’re citing studies that show correlation, not causation. Medicaid doesn’t cause bad health; people who qualify for Medicaid are more likely to have bad health for other reasons. There’s a huge randomized controlled trial of Medicaid going on in Oregon right now, and that’s the kind of study you’d do to prove causation. It’s showing that Medicaid is good for health.

Expanding Medicaid is not only a good thing to do in terms of finances, it is “good for health.” It is good public policy. It is the right thing to do. And it does save lives, as was suggested in the Globe article. A woman named Patricia Bailey was visiting a local Joplin clinic that serves a significant number of folks on Medicaid:

Bailey, 61, of Joplin, said she has been on Medicaid for the past four years. Without it, she said, she wouldn’t have sought treatment that included three hospitalizations.

“I couldn’t have afforded it. I think I’d probably be dead,” she said.

More than the money, more than anything else, as Missourians, as Americans, we should expand Medicaid coverage because for some folks, it is a matter of life and death.

by R. Duane Graham on February 14, 2013  •  Permalink
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Posted by R. Duane Graham on February 14, 2013

https://duanegraham.wordpress.com/2013/02/14/missouri-medicaid-expansion-a-matter-of-life-and-death/