It’s the duty of health care professionals to sound the alarm when there’s a crisis.
As a radiologist practicing in northern Missouri for the past 22 years, I continue to watch that crisis steadily unfold.
In my practice, we see uninsured patients forced to choose between paying for rent and groceries versus an emergency room visit. Faced with that choice, their conditions go untreated, developing into a late-stage illness that could have been prevented had they sought medical treatment sooner.
But they didn’t, because their jobs don’t offer insurance and they can’t afford basic coverage on their own. All the while, our rural hospitals in Missouri and nationwide are going broke and shutting down, forcing patients (and ambulances) to drive 50 or even 100 miles as what should be routine care threatens to escalate into matters of life or death.
For years, our state has left more than 230,000 hardworking Missourians without access to affordable health care. But thanks to our state’s ballot initiative process, and the Healthcare for Missouri Medicaid expansion campaign, Show-Me State voters can make the changes that our elected leaders have consistently refused to.
Thirty-six states have already embraced Medicaid expansion, including the Missouri border states of Arkansas, Kentucky, Nebraska, Illinois and Iowa. Two other neighboring states — Kansas and Oklahoma — are expected to soon join those ranks.
All the while, those three dozen states receive the federal dollars that Missouri refuses, with multiple projections pegging the lost federal revenue as high as $1 billion annually.
Literally dozens of research studies on the economic and health-related impact of that move show that Medicaid expansion generates increased economic activity and budget savings, with no overall increase in state general revenue expenditures.
Notably, none of those three dozen states have reversed course because of excessive implementation costs.
Among the panoply of studies is one from earlier this year analyzing Medicaid expansion in Arkansas, Indiana and Ohio — three states whose politics closely resemble those of Missouri.
In Arkansas, savings from Medicaid expansion led to a state income tax cut for the middle class, the Health Management Associate researchers found, providing more than $100 million in annual relief to middle-class taxpayers.
Ohio, under Republican Gov. John Kasich, gained more than $300 million annually from revenue and savings generated by expansion.
And Indiana, under then-Gov. and now Vice President Mike Pence, opted in early enough in 2015 to take advantage of a 100-percent federal match (Missouri’s match would be capped at 90 percent) “with no substantial impact on the state budget or general fund,” the study concluded.
The same report found that expansion led to more than 19,000 new jobs in Louisiana and 31,000 new jobs in Colorado.
Missouri could expect comparable benefits, with “savings and revenue opportunities that significantly exceed the state’s cost of implementation,” the research found. The new federal funds would offset current state health spending in Medicaid, prison health, mental health and substance abuse treatment.
More than 150 groups have endorsed the Healthcare for Missouri campaign, a nonpartisan coalition that includes some of the state’s most powerful business voices, such as the St. Louis and Greater Kansas City Chambers of Commerce and the Civic Council of Greater Kansas City.
Washington University has pledged its support, as have statewide medical groups such as the Missouri Hospital Association, Missouri Primary Care Association, Missouri Nurses Association and major hospital systems from Springfield to St. Louis.
With an early May deadline, Healthcare for Missouri has already collected more than 75 percent of the signatures needed to get on the November ballot, growing support not just in the state’s biggest cities but in communities stretching from Hannibal and Poplar Bluff to Rolla, Joplin and St. Joseph.
Rural Missouri has been hit particularly hard, with 10 hospital closings since 2014, eight of which were south of Interstate 70. According to industry analysts, an equal number of rural Missouri hospitals continue to face high financial risk.
For those who say we can’t afford Medicaid expansion, the reality is that we’re already paying for it but not receiving any of the benefits.
That needs to change. And it’s time to let the voters of Missouri decide for themselves.
Dr. James Adams is a Kirksville radiologist, small business owner and assistant professor at A.T. Still University’s College of Osteopathic Medicine.