Missouri Medicaid Expansion: Now More Important Than Ever

By Heidi B. Miller, M.D.
As a primary care doctor, I cringe when I am paged on-call at 2 a.m. by a patient with chest pain, who won’t go to the emergency department because of lack of insurance.
With sadness and frustration, I must persuade the patient that this is an emergency, and he could die from a heart attack. Debating financial devastation versus life-saving care on the phone with a man in pain, while the clock is ticking is a foolish injustice.
Our state has left more than 230,000 Missourians similarly without access to affordable healthcare. Catching a heart attack early or assuring healthcare to prevent heart disease in the first place is an obvious, humane, and cost-effective strategy.
The plight of my uninsured patients is made even more bitter, knowing that our tax dollars are currently going to Washington to fund Medicaid expansion for 36 other states.
That can change, now that petitions from nearly 350,000 Missourians asking the state to let voters decide on Medicaid expansion have been submitted to the Secretary of State’s Office.
The Healthcare for Missouri campaign on Friday submitted nearly twice as many signatures from Missourians as required, a testament to the widespread interest across the state in making this change.
With Medicaid expansion in Missouri, my diabetic patient won’t run out of their insulin and incur a $5,000 hospital visit due to lethal glucose levels.
These are our patients: servers, delivery personnel, shuttle drivers, farm workers, home health aides, store clerks. Most working at or near minimum wage, unable to afford insurance, and needing their essential health to work their essential jobs.
And that was before the pandemic tragically reminded us that access to healthcare is more important than ever.
With Medicaid expansion, we can care for our own citizens and our own economy, bringing more than a billion of our tax dollars back home from Washington each year.
Three dozen other states have already done so, including our neighbors in Illinois, Kentucky, Nebraska, Iowa, and Arkansas, where officials reported using savings from the expansion to enact a middle-class income tax cut and reduce payments previously allocated to the uninsured.
Every state that has expanded Medicaid has chosen to keep the program in place – in no small part due to its positive economic impacts.
Never before in Missouri has the interdependence of our health been more apparent, and the dependence of our economy on our collective health been more evident.
Medically, I recognize an emergency requiring immediate attention. Publicly, I recognize the dire and immediate need for increased healthcare access in this state.
Medicaid expansion will make our families healthier, our communities safer, and our economy stronger. It will keep rural hospitals open, create thousands of new jobs, and allow hundreds of thousands of hardworking Missourians with jobs that don’t provide insurance get access to life-saving care.
Missourians would take the shirt off their back to help a patient injured and bleeding in front of them. Likewise, I believe Missourians, who see the current injured and fractured state of health coverage in our state, will understand the need for Medicaid expansion. (Heidi B. Miller M.D. is a primary care doctor at Family Care Health Centers in St. Louis and medical director for the St. Louis Regional Health Commission.)