The Joplin Globe, Joplin, MO

March 7, 2013

Your View: Legislators should reconsider

By Irene Marshall
Special to The Globe

JOPLIN, Mo. — According to The Joplin Globe (Feb. 18, “Local lawmakers discuss Medicaid expansion”), each of our local legislators who were present opposes Medicaid expansion.

One of their arguments is the federal government could change the rules and increase the state’s share of the expansion cost.

This is not a concern. If such changes were made and they resulted in a significant negative impact, Missouri could opt out of the expansion without penalty.

Another argument is the state can’t afford its share of the cost. “Local lawmakers, all Republicans, who touched on the issue, said the expansion could leave the state with huge costs after the first three years.” (Joplin Globe)

While the federal government will pay 100 percent of the expansion cost in 2014-2016, it is true Missouri will start sharing the cost in 2017. That will begin at 5 percent and rise gradually to 10 percent in 2020. It will stay at 10 percent in all following years.

What will the cost be in dollars? The University of Missouri School of Medicine has published a study on the economic impacts of Medicaid expansion on Missouri. Its analysis says the state’s cost will be $58 million (5 percent share) in 2017 and will increase gradually to $119 million (10 percent) in 2020.

So how will Missouri taxpayers pay for this? According to the study: “The Medicaid expansion will generate nearly $856 million in additional state and local taxes from 2014 to 2020, due to the increase in jobs and economic activities within the state.” The ongoing annualized amount will be at least $122 million (the average), which is more than the cost in dollars.

However, there are additional economic benefits that would add to the tax base. For example, the cost of insurance premiums will be reduced, because those premiums will no longer be subsidizing medical services to uninsured individuals, e.g., un-reimbursed emergency room visits.

“Across the period 2014-2020, privately insured individuals and families could potentially save nearly $1 billion due to reductions in premiums,” the study says. When those savings are spent, they will contribute to Missouri’s economy and have a ripple effect, resulting in additional tax revenues.

It appears to me the overwhelming weight of evidence supports Missouri’s participation in Medicaid expansion. I implore our local representatives to reconsider their position in light of this evidence.

Irene Marshall