Rep. Cleaver: Missouri can’t afford politicians disobeying the voters on Medicaid

Last August, a majority of Missourians who traveled to the polls voted for Amendment 2, sending a clear message to our state legislators: We want to expand Medicaid. However, less than eight months later, state House GOP lawmakers announced their intention to overrule the will of Missourians by voting against funding for the expansion. With additional federal funding from COVID-19 relief reducing Missouri’s share of the cost, the state legislature’s refusal to implement voter-approved Medicaid expansion isn’t just undemocratic — it’s fiscally irresponsible while denying health care to Missouri’s most vulnerable populations.

As Missourians grapple with the fallout of the COVID-19 pandemic, the consequences of a failing health care system could not be more apparent. Missouri’s Republican lawmakers must respect the democratic process and fully fund Medicaid expansion.

Since passage of the Affordable Care Act — which draws much of its core pillars from a health care plan formulated by Republican President Richard Nixon and put into practice by Republican Massachusetts Gov. Mitt Romney — a few GOP-led states, including Arkansas, West Virginia and North Dakota, put people before politics and immediately implemented Medicaid expansion in 2014.

Since that time, however, voters in numerous states have been forced to expand Medicaid through ballot initiatives, as Missouri, Nebraska and Oklahoma have all done in recent years. The passage of Amendment 2 last August should have put the political tribalism of this issue behind the Show-Me state. Unfortunately, ideological rigidity at the expense of the will of the people continues to block the measure from being implemented.

It is no secret that underserved communities — such as those in rural Missouri and the urban cores — bear the burden of inequities in the American health care system. Passage of Amendment 2 extended health coverage to more than 230,000 low-income Missourians and gave hope to struggling rural hospitals across the state. As a result, families of four with incomes of up to $35,670 and individuals that earn $17,744 or less should finally experience the sense of security that comes with reliable health care. Before Amendment 2, these individuals earned just enough to be ineligible for Medicaid, but far too little to afford quality health insurance.

Since 2014, 10 rural hospitals in Missouri have closed, forcing rural Missourians to travel further and pay more for lifesaving care. Expanding Medicaid would open the door to billions of federal dollars our state can use to keep these hospitals up and running, ensuring rural Missourians have the care they need and deserve.

COVID-19 has exposed pervasive inequities in Missouri’s health care system. Throughout this public health crisis, we’ve seen that low-income individuals have been disproportionately infected, hospitalized and dying from the coronavirus. Now that Missouri’s vaccine rollout is accelerating, Medicaid expansion should play a key role in the state’s post-pandemic recovery.

Thanks to the passage of the American Rescue Plan, states that opt in to Medicaid expansion will benefit from an increase in the federal government’s cost share for implementation. In just two years, this could save Missouri more than $1 billion. These savings should be a welcome windfall for fiscally conscious legislators. The past year has devastated state and local economies, heightening the need for this federal relief. Nearly 600,000 Missourians have been infected with the coronavirus, and many individuals will need long-term care after COVID-19 is no longer on the nightly news. Passing up the opportunity for increased federal dollars would be a wasteful decision that communities across Missouri simply cannot afford in this moment.

Although Republicans claim expanding Medicaid would be an unbearable weight on the state budget, the numbers speak for themselves: Medicaid expansion saves money. In fact, expanding Medicaid has resulted in net savings for many states, and would boost our state budget by creating thousands of new jobs and increasing access to federal funds. Countless reports have confirmed that Medicaid expansion is financially savvy governing.

Both the Missouri Chamber of Commerce and AARP Missouri supported Amendment 2 last year because they know access to health care is good for the economy. With $2.8 billion in federal relief from the American Rescue Plan, Missouri can afford Medicaid expansion’s $130 million price tag this year. If Republicans in the state legislature truly care about fiscal responsibility, they should be advocating for Medicaid expansion’s cost saving benefits.

Passage of Amendment 2 demonstrated that progress is still possible when voters come together around commonsense policies. Ballot measures give citizens the power to initiate legislation in situations where state lawmakers refuse to do what is in the best interest of the people. When Missourians from both parties and across the state called on the General Assembly to implement Medicaid expansion, lawmakers were tasked with carrying out the will of the voters. Sadly, the battle to realize that directive and overcome obstructionist politics continues. However, until the will of the voters is carried out, Missourians must insist to the state legislature that Medicaid be expanded.

Emanuel Cleaver II represents Missouri’s 5th District in the U.S. House of Representatives.