Regarding the editorial “After refusing Medicaid expansion, Missouri Republicans now endanger the whole program.” (June 10): The Missouri Legislature rejected funding for Medicaid expansion against the wishes of voters, citing financial concerns; however, these concerns are not grounded in fact. According to Gov. Mike Parson’s budget, the proposed $130 million for Medicaid expansion amounts to just $20 in additional spending per Missourian. In 2019, the Center for Health Economics and Policy at Washington University projected that the actual cost would likely be far lower, stating “expansion of Medicaid in Missouri is close to budget neutrality and actually has an estimated savings of $39 million.” This is because the federal government’s cost matching ratio will rise to 90% from 65% should expansion take place.
Tragically, Missourians without health insurance face a great deal of financial insecurity; two-thirds of bankruptcies in the United States are linked to medical bills. Missouri has a low threshold for earning “too much” to qualify for Medicaid. A family of three with an annual income of just above $5,400 would not qualify in Missouri without Medicaid expansion, while those earning up to $30,300 would qualify just across the border in Illinois where Medicaid has been expanded.
Adults without children are generally ineligible regardless of their income. As a medical student, it is heartbreaking to watch patients suffer because legislators refuse to accept federal funding. In a state with a projected budget surplus of about $7.3 billion in various accounts, insuring 300,000 Missourians for, at most, the price of a couple movie tickets per resident, should be an easy decision.
Zach Neronha • St. Louis
Washington University School of Medicine
