Ed Emery provides information on Amendment 2 (then tells us places where we can find more information against it)

(From Sen. Ed Emery, R-Lamar)

In August, Missouri voters will be asked to consider expanding a government program that already consumes nearly one-third of the state’s budget.

Amendment 2, placed on the ballot by initiative petition, would require Missouri to provide health care coverage to any adult, age 19-64, who earns less than 133 percent of the federal poverty level.

In 2010, Congress passed the Patient Protection and Affordable Care Act, sometimes referred to as “Obamacare.”

The most comprehensive expansion of health care coverage since the creation of Medicaid and Medicare in 1965, Obamacare has endured a number of legal challenges and legislative revisions since its passage. 

In 2014, the Supreme Court ruled states could opt-out of a provision requiring Medicaid coverage for low-income residents. Missouri is one of 14 states that have chosen not to expend taxpayer funds to insure able-bodied adults.

In Missouri, Medicaid is administered by the Mo HealthNet program. Coverage is generally limited to low-income children, parents of low-income children, pregnant women and blind or disabled individuals.

More than 60% of those receiving benefits are children. Low-income seniors may also receive Medicaid benefits in addition to Medicare.

Currently, about 900,000 Missourians receive Mo HealthNet benefits. That’s one out of every seven Missourians.

The Kaiser Family Foundation, a proponent of Medicaid expansion, predicts passage of Amendment 2 will provide taxpayer-funded health insurance to an additional 200,000 Missourians. The Urban Institute puts the number closer to 350,000. Backers of Medicaid expansion argue that most of the increased cost will be paid by the federal government – ignoring the fact that Missourians pay federal taxes.

Opponents of expansion worry the state share of Medicaid expansion will bankrupt available resources and only grow over time.

In 2019, the Missouri Department of Social Services published a review of the Mo HealthNet program showing Medicaid is consuming an ever-larger share of state resources, increasing from 17 percent in 2009 to 24 percent in 2018.

The department predicted Medicaid would require 30 percent of Missouri’s general revenue by 2023. General revenue – the portion of the state budget you pay for in taxes – is only part of the picture, however.

Medicaid expenditures are also paid with federal funding (your tax dollars) and fees and taxes paid by health providers (and inevitably passed along to patients). Viewed from the perspective of the total state budget, Medicaid is already Missouri’s single largest expense. 

With health care costs outpacing growth in the economy even before COVID-19 took its toll, we face the prospect of serious challenges to Missouri’s budget.

If voters approve Amendment 2, the taxpayers of Missouri will provide health care insurance to able-bodied individuals earning less than $17,608 per year (or a family of four who earn less than $36,000).

One can argue that providing insurance to those who struggle to afford care is an act of compassion, but where will the money come from? Ultimately, it will come from you, the taxpayer. But in terms of the budget, something else will need to be cut to cover the added cost. Will it be schools? Roads? Public safety? Should we raise taxes to cover the added expense?

Busting the budget or raising taxes are not our only options. In my opinion, greater price transparency and further reliance on telehealth technology can help make health care more affordable. We can also combat the run-away cost of health care by reforming oversight of the medical profession and increasing competitiveness.

I hope all voters will educate themselves about the costs of Medicaid expansion. I have found compelling arguments against Amendment 2 from the Americans For Prosperity organization and look forward to a series of town halls the group will host in cities across Missouri in June and July. If you’d like to learn more about this topic, I’d encourage you to seek them out.