Advocates Demand Missouri Expands Medicaid Coverage by 2014

Grassroots leaders and organizations in St. Louis converged Wednesday to announce a campaign to expand Medicaid coverage in Missouri, a move they say is critical for the state's working poor.

During a press conference at Kirkwood Baptist Church, faith leaders, advocates and Medicaid customers called for Missouri to adopt legislation that expands coverage to anyone making 138 percent of the Federal Poverty Level (FPL).

Under the current system, Missouri does not offer Medicaid to single adults, unless they are disabled, and parents or caretakers with dependent children must make 25 percent of the FPL to receive Medicaid. (See PDF for comparison of current eligibility requirements versus those under an expanded coverage system.)

"Missouri has one of the stingiest Medicaid programs in the country," Professor Sidney Watson from Saint Louis University School of Law told attendees. "It's harder to qualify here than in other states."

She said the adoption of expanded Medicaid coverage would reduce Missouri's uninsured population of 877,000 by a third. Caring for this population puts a strain on communities and hospitals, she added. 

Multiple presenters discussed the problem with a Medicaid "spend-down." Those who do not meet FPL requirements could qualify for Medicaid if they subtract medical expenses from their income to meet requirements, according to Missouri's Medicaid program MO HealthNet.

"To give me Medicaid with a spend down is like giving me a gift I can't open," Yvonne Samuel, a current Medicaid customer and representative of CHIPS said. "I want to be able to open that gift."

James Shortall, who suffers from bipolar disorder, said expanded Medicaid coverage would help him in his road to recovery. Shortall does not have insurance and does not qualify for Medicaid. As a result he relies on hospitals and emergency rooms for health care needs which he says has become a financial burden. Shortall spoke as a representative of NAMI.  

Watson noted contract and seasonal workers would benefit from the expanded coverage. Christopher Wood, of Paraquad said the move would help those with disabilities. 

"People are afraid of pursuing meaningful full-time jobs because they're afraid of loosing their insurance. This would mean bringing disabled people into more fully active roles in their communities," said Christopher Worth, of Paraquad.

Presenters called on Missouri's legislature to pass expanded coverage this year to go into effect in 2014. Federal funding would cover the expansion for the first three years with Missouri never having to pay more than 10 percent of the cost.

Expanding Medicaid coverage to anyone who makes 133 percent of the FPL was originally part of President Barack Obama's Patient Protection and Affordable Care Act, but the Supreme Court struck down the provision, leaving states to decide whether they will expand coverage, according to U.S. News and World Report. 

Presenters called on attendees to write to their state representatives in support of expanded Medicaid coverage.

"Missouri is at a crossroads of what kind of state it wants to be," said presenter Megan Burke, a senior policy analyst with Paraquad.