The St. Louis-based nonprofit, nonpartisan group Missouri Foundation for Health held a community forum in Columbia at the ARC Monday night about the state’s Medicaid expansion debate. The foundation’s director for health policy Ryan Barker presented the pros and cons of the expansion to an audience of about 45 people, before opening up the floor to questions.
Barker explained Missouri's current Medicaid eligibility criteria, which is very generous to children (in families making up to 300 percent of the federal poverty level, children are still eligible for Medicaid), but not so generous to adults (parents are only eligible only if he or she makes 18 percent of the federal poverty level, which means single moms with two children have to make less than $3,504 a year to get Medicaid, while childless, able-bodied, low-income adults under 65 are not eligible at all). Under the terms outlined in the Affordable Care Act, Medicaid could be expanded to cover families and individuals making up to 138 percent of the federal poverty level.
Barker has hosted the forum in five other Missouri cities before Columbia.
“Most Missourians don’t understand what is this issue of Medicaid expansion and what is being debated in Jeff City right now,” Barker said. “And the foundation really feels that all Missourians should be educated in this issue and make their voice heard to their policymakers.”
Health educator Dean Andersen works to promote smoke-free workplaces around the state. He said learning more about the Medicaid at the forum helped him solidify his support of the expansion.
“I believe that access to health care is a social justice issue,” Andersen said. “I believe that we have a responsibility to try to come up with good solutions to the problem of providing health care to everybody in a way that's accessible and affordable.”
Barker was careful to note that the foundation is holding the forum to simply inform the public about Medicaid expansion -- not influence them to one decision or another.
Barker said the most of the audience members who asked questions at Columbia's forum were more well-informed than in the other forums. Many in attendance were local healthcare providers, such as Family Health Center's Andrew Quint, or social justice advocates, such as Jeanette Mott Oxford of the Missouri Association of Social Welfare.
But in all the other forums he’s hosted, Barker said more members of the general public attended. Most of them were mainly concerned with the high cost of the expansion. If Missouri decides to expand Medicaid next year following the terms recommended by the Affordable Care Act, the federal government is expected to fully cover the cost for the first three years. But after 2020, the state would be paying 10 percent of the expansion’s total cost. The state budget office says that for fiscal year 2020, Missouri could be paying up to $259 million to cover the expansion.
Two committees in the Missouri House of Representatives have struck down the House Democrats' proposal to expand the state's Medicaid. That proposal, in line with Gov. Jay Nixon's proposal, sought to expand Medicaid eligibility to families and individuals making up to 138 percent of the federal poverty level. Rep. Jay Barnes (R-Jefferson City) has proposed his own expansion plan, which would cover up to families and individuals making 100 percent of the federal poverty level. Policy analysts worry that if Missouri doesn't meet the ACA requirements, the federal government would not cover the first three years of the expansion.