The Joplin Globe, Joplin, MO


April 3, 2014

Other Views: Bleeding jobs

One. Thousand. Jobs. That is what Missouri’s health care industry has already lost because the Republicans who control the Missouri Legislature have refused to expand Medicaid to the state’s growing class of working poor.

On March 26, the Missouri Chamber of Commerce and the Missouri Hospital Association presented the number at a Capitol news conference in Jefferson City, part of a joint effort to continue to plead with Republicans to pass Medicaid expansion and stop the economic bleeding.

Every lawmaker in the Capitol at one time or another, perhaps in every public speech they have made during an election campaign, has talked about creating jobs. It’s usually a bit of an esoteric exercise; neither party has much of a solution for job creation. Republicans want to cut taxes in an already low-tax state. Democratic Gov. Jay Nixon wanted to give $2 billion worth of corporate welfare to the Boeing Co.

But real people have lost, and are continuing to lose, real jobs. Today there are 1,000 fewer health care workers in Missouri because lawmakers refused to expand the state’s Medicaid system as called for in the Affordable Care Act.

A key provision in the law changes how hospitals are reimbursed for providing health care for the poor. It’s a good change that makes the health care system more efficient.

Before the Affordable Care Act, poor people without health insurance often ignored health problems until they became serious enough to require care. Then they would show up at the emergency room and eventually get the care they needed, usually far more expensive care than a simple doctor visit would have entailed, if only they could have afforded a doctor.

The federal government reimbursed hospitals for that care. Some of the money came from those of us who have insurance, through higher rates.

Under the ACA — at least in the states that are expanding Medicaid — those same working poor people can now get health insurance, either from the state or a private exchange. (According to numbers released on March 27, 6 million Americans have done just that.) The federal government reduced payments to hospitals, instead investing up-front in providing more people access to health insurance.

But here’s what’s happening in Missouri and the other states that haven’t expanded Medicaid: The working poor still don’t have insurance. And they show up at the emergency room, and the care isn’t reimbursed by the federal government.

Hospitals and the health care industry lose.

Missouri loses.

One. Thousand. Jobs.

The number is going to climb, and more Missourians are going to die prematurely, unless the Legislature decides that one of its most important industries, and the people it serves, are more important than their disdain for the man who resides in the White House.

— The St. Louis Post-Dispatch

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