Support for Missouri Medicaid Expansion: A Statement from the Brown School Dean

Washington University Chancellor Andrew D. Martin and Dean of the School of Medicine, David Perlmutter, recently announced the university’s support for the Healthcare for Missouri initiative, an effort to put the expansion of Medicaid in Missouri before the voters.

The expansion of Medicaid across the state offers a critical opportunity to disrupt the widening health disparity gap and advance health equity. And not just for the 200,000 Missourians who would become eligible for healthcare coverage through the expansion – access to health care for low-income individuals is an investment in the state’s economic health. As health disparities persist across our nation and in our communities, state Medicaid programs are well positioned to reduce these inequities, and improve health outcomes for our most vulnerable citizens.

The lack of access to affordable health care often results in the lack of preventive care and the postponement of medical attention, which can worsen a health issue that could have been easily treated. Furthermore, families can face serious financial consequences when they must seek care. The safety net system of clinics and hospitals they may resort to are under-resourced and spread thin: in the last five years, for example, Missouri has lost six rural hospitals.

At the Brown School, many of our faculty have devoted their research agendas to eliminating health disparities. Medicaid is a vital policy tool to help close the healthcare coverage gap, reduce deeply entrenched inequities in the healthcare delivery system, and improve the lives of thousands of poverty-impacted families. Our faculty have produced overwhelming empirical evidence in support of Medicaid and its benefits, including the following:

• Expanding coverage for adults increases the likelihood that eligible children will be enrolled, have access to preventative healthcare such as well visits, and experience continuity of care.
• Families who get health insurance through the Affordable Care Act (ACA) are significantly more likely to make their rent and mortgage payments than are those who remain uninsured.
• By reinstituting coverage of therapy services for Medicaid beneficiaries, there is significant potential to help reduce opioid dependency.
• Medicaid expansion states saw a 46% reduction in coverage gaps between different socioeconomic levels.
• Medicaid is comparable to private insurance in treating children with cancer, providing evidence that public outlays on Medicaid are well spent.
• Increases in federal funding, through programs such as Medicaid, are strongly associated with reductions in infant mortality rates.
• Low-income, late middle-aged Americans with private insurance or unstable coverage were more likely to have higher out-of-pocket expenditures and financial burdens than those with public insurance, such as Medicaid.

And more research is ongoing.

Missouri is one of only 14 states that has yet to expand Medicaid, and a recent fiscal analysis conducted by the Center for Health Economics and Policy showed that expansion is close to budget neutrality and actually has an estimated savings.

I urge you to read The case for Medicaid expansion in Missouri from Chancellor Martin and Dean Perlmutter, which provides a powerful argument for expansion. Greater still, I urge you to consider your role in helping thousands of fellow citizens lead heathier, more productive lives.

To learn more about the Healthcare for Missouri initiative and how you can help, visit:
https://www.healthcareformissouri.org/

 — Mary M. McKay
     Neidorff Family and Centene Corporation Dean
     Brown School at Washington University in St. Louis

Related articles and publications:

Effects of Medicaid Expansion on Coverage, Access, Outcomes, and Costs: Implications for Missouri
Does Health Insurance Status Affect Childhood Cancer Survival?
Therapy Services Reinstated in Missouri Medicaid After Key Policy Recommendations
Home Delinquency Rates Lower Among ACA Households
Trends in Medicaid Enrollment and Spending in Missouri