Senator Cindy O’Laughlin’s Column for the Week of November 4, 2019

Discussions about health care continue around our state, and it is important for Missourians to understand why expanding Medicaid under the Patient Protection and Affordable Care Act is not a fiscally responsible decision for Missouri. I truly believe all Missourians should have access to quality health care, but having access to care does not mean we expand what is already a failed government program.  As lawmakers, we must be responsible for your taxpayer dollars.

With increasing health care costs, I believe it is inevitable the Missouri state budget will be consumed by the cost of Medicaid if eligibility is opened to include able-bodied, working Missourians. The cost of Medicaid has increased by $3.7 billion since 2009, and it continues to rise. In 2018, Medicaid spending made up 24 percent of the state’s general revenue budget, and it is projected to eat up approximately 26 percent by 2023.

Some claim expanding Medicaid would actually “save” costs. This claim of expanding Medicaid to working age, able-bodied adults in the name of saving money can only be made by government. Reasonable people understand that when you provide something it costs you. The more you provide, the more it costs. According to the Foundation for Government Accountability, the cost projections pushed by expansion advocates estimated state spending would increase by 4.5 percent. Nationwide, state Medicaid spending alone grew by 184 percent, so if expansion occurred can anyone reasonably believe the costs will only grow by 4.5 percent?

During next year’s general election there will be at least three ballot measures that will give Missourians the opportunity to vote on this issue. These initiatives are largely supported and funded by outside groups. As your senator, I believe it is my job to clearly explain why these measures will ultimately lead to tax increases for you and reduced spending on education. I mention education because it is the next largest category of funding, which we would be forced to reduce in order to fund the expansion. That decision along with a tax increase for all Missourians would likely be necessary to cover expanded Medicaid (welfare).

Medicaid expansion is a Trojan Horse sold as an answer to the health insurance market, but it is actually an effort to place more people on welfare with the costs placed squarely on the backs of the working taxpayers. We need to be seeking answers in exactly the opposite direction which means we need to reform regulations that Obamacare placed on the insurers ultimately running many insurers out of the market. With reduced regulation, our health insurers could once again offer coverage to working Missourians at a price that is affordable.

In the upcoming months, I plan to work with my colleagues to increase access to affordable health insurance and health care. My colleagues and I are already making hard decisions regarding other areas of the state budget, and I do not believe that expanding Medicaid will do anything but drive up taxes and reduce other necessary spending at the state level. We can do better and we must do better.

Please feel free to contact me in Jefferson City at (573) 751-7985. You may also email me at