Available. Accessible. Affordable.
Health Forward Foundation has been working toward these goals for health care services in our two states since our founding in 2003. While we realize health entails far more than just access to care, having quality health care still matters.
I arrived at Health Forward six years ago this week. It was a big week. Not just for me, but for our county. It was the roll out of the Affordable Care Act Marketplace. My first weeks were dominated by media interviews and conversations with partners about the impact the marketplace would have on access to health care in our region.
What I heard then, unfortunately, still rings true today. While the marketplace did expand coverage to some, many of those most in need in our region fell in the insurance gap, thanks to the decision that both Kansas and Missouri made to not expand Medicaid.
The ACA allowed states to voluntarily include low-income people under their own state’s Medicaid coverage. At the time, Missouri and Kansas were two of many states that elected not to. However, over the years, more and more states have reversed that decision, leaving just 14 states which have not. Unfortunately, Missouri and Kansas are among them.
That decision has cost us in dollars and in lives.
As most of you know, I am a scientist at heart and as such rely heavily on data. The data from states that have moved forward with Medicaid expansion is as compelling as it is rich. These are studies from government, research institutions, universities, and policy organizations. You can access the 708 citations here.
I’d like to highlight what that data tells us about the impacts of Medicaid expansion:
- States see improvements in early stage breast cancer diagnosis, reduction in infant mortality, improved diabetes care, and improved treatment for asthma.
- For rural areas, there is a particularly large improvement in insurance access. As of 2015, nonelderly individuals in rural areas within non-expansion states were nearly twice as likely to be uninsured as those living in expansion states (15 percent vs. 9 percent).
- 25 of these studies showed increased access to behavioral health services and medications.
- Medicaid expansion reduces inequity in coverage. Researchers have found that the coverage gap between blacks and whites declined from 11.0 percentage points in 2013 to 5.3 percentage points in 2017. The gap between Hispanics and whites, meanwhile, dropped from 25.4 points to 16.6 points. For nearly all groups, uninsured rates were roughly twice as high in non-expansion states in 2016.
Aside from all these figures, are the real stories. People report that they feel in better health. That is the point. People who are healthy enough to work, raise families, and fully participate in their communities.
So here we are. Six years later. Watching other states improve health access and outcomes while our states struggle to provide access to care. Still asking, why not Kansas and Missouri?
As I near the end of my time as president/CEO of Health Forward, I’m proud that we remain committed to advocating for available, accessible, and affordable health care. We know that Medicaid plays a vital role in that work.
Today, I feel as optimistic as I have in the past six years. In Kansas, legislative leaders have pledged to take up the debate on Medicaid expansion in the 2020 session. And this week, Gov. Laura Kelly announced that she will re-convene a working group to study the costs and benefits of Medicaid expansion models in other states.
And there was a big announcement in Missouri, too. Health Forward is among many partners of Healthcare for Missouri, which announced plans to launch a campaign to put Medicaid expansion on the ballot.
The newly formed campaign will ask voters to bring home more than a billion of Missourians’ tax dollars from Washington, D.C., every year to keep rural hospitals open, boost the state’s economy, and deliver health care to people who have lower-paying jobs that don’t come with insurance.
A signature collection drive is happening with volunteers from around the state. The coalition needs to collect 172,000 signatures from registered voters to put Medicaid expansion on the November 2020 ballot.
Now, more than ever, I’m convinced this is the moment.
I encourage you to visit healthcareformissouri.org to stay informed, to share your story, and to learn where you can go to to sign the petition.