Medicaid Expansion: An Experiment Missouri Can’t Afford
Year after year, I believe Missouri voters have been very clear about Obamacare: we don’t want it and we can’t afford it. Because Obamacare supporters have failed to advance Medicaid expansion in the General Assembly, they’ve turned to the initiative petition process. This week, a collection of special interest groups released a report on how they believe Missouri can expand Medicaid and avoid the fiscal disaster other expansion states are seeing; their conclusions aren’t exactly promising.
First and foremost, I believe supporters base their entire plan on the assumption that a Missouri Medicaid expansion will somehow coincide with perfectly synchronized program reforms, new taxes and shifting around complex federal matching funds. I don’t need to tell you that’s easier said than done, and I’m not confident it can be done. Just look at the initiative petitions for medical marijuana: various competing versions passed at the ballot box, and I believe the resulting marijuana licensing process has been an absolute disaster. Why would Medicaid expansion be any different?
Secondly, Missouri’s Constitution creates an environment where it’s very easy to cut taxes, but nearly impossible to raise taxes. As Medicaid costs soar, and I believe they will continue to increase, where will that extra money come from? Do proponents really think Missourians will go back to the ballot box to approve new taxes, specifically new taxes on health insurance? When push comes to shove, the money needed to sustain Medicaid will have to come from public schools and higher education. With record employment and a booming economy, why are we taking money out of the classroom and using it to put more people on welfare?
Look at other states that have expanded Medicaid. NPR has reported New York is facing a $6 billion deficit as a result of skyrocketing Medicaid expansion costs. How will New York tackle this shortfall? New York lawmakers are considering raising taxes, forcing municipalities to cover more Medicaid costs, cutting provider reimbursements and making it harder to qualify for coverage.
Finally, who is funding this proposed Medicaid expansion initiative petition campaign? The truth is Missourians will never have a complete picture because, as reported by the St. Louis Post-Dispatch, significant funds are coming from secret dark-money groups outside Missouri. Who funds these groups and why are they suddenly extremely interested in changing Missouri’s laws?
In my opinion, these dark-money interests are using the initiative petition process because they know our Legislature will not expand Obamacare. I encourage voters to get educated on the true costs of this initiative, however, because Missouri cannot afford this expansion.
Medicaid expansion is undoubtedly a serious issue that requires serious discussion. That discussion must include a realistic assessment of the costs and how Missouri would pay those costs. When voters reject higher taxes, the only place in the budget left to cut is education. When the economy is booming and a record number of people are working, should we be investing in schools or in expanding welfare?
It is an honor to serve you in the Missouri Senate. Please do not hesitate to contact my office at (573) 751-3678 or by email at dave.schatz@senate.mo.gov if you have any questions or concerns — we are honored to serve you.