Sen. Ed Emery’s Legislative Report for July 17, 2020

Vote ‘No’ on Medicaid Expansion

“The problem with socialism is that you eventually run out of other people’s money.”  ―  Margaret Thatcher

The stated goal of the federal Affordable Care Act, or “Obamacare,” was to provide health care to all Americans who could not otherwise afford it. From my perspective, the real purpose behind Obamacare was to bring about socialized medicine, which is sometimes referred to as a “single-payer” health care system. In my opinion, an important part of transitioning America to such a system is Medicaid expansion. Blocked by the courts as a mandate of Obamacare, it has fallen to states to decide whether to expand the Medicaid entitlement to able-bodied adults. In August, Missourians will be asked to decide whether to expand Medicaid in our state. My recommendation is to vote “no” on Amendment 2, and to inform as many others as you can about what I believe will be the disastrous impacts of this self-serving and costly proposal.

The first question we should ask is whether tax payers should be forced to pay for health care for able-bodied adults? According to research provided by the Foundation for Government Accountability (FGA), two-thirds of those who would immediately qualify for expanded Medicaid benefits in Missouri already have private insurance. The FGA says many of these would be forced onto Medicaid roles by existing federal law, and could not be removed, even if they later failed to qualify. Moving from private insurance to Medicaid would reduce reimbursement rates for doctors and hospitals, the group says. In some states, these changes have hurt hospitals and resulted in layoffs of medical personnel.

In the 34 states that have expanded Medicaid, the FGA study shows the number of new entitlement recipients has exceeded projections by an average of 110 % – in other words, more than double projections. The same states have seen the cost of expansion exceed projections by an average of 157 %. The promised federal subsidy has fallen from 100% to 95%, and now to 90%. In the face of ballooning federal debt, I believe it will almost certainly continue to decline. Missouri cannot print money like the federal government, so where will this money come from? At least 12 states have raised taxes and fees or cut back on Medicaid reimbursement rates.

What about quality and accessibility of health care? Missouri already has waiting lists for special needs care. I fear the able-bodied adults that will be added will go to the front of the line, severely harming the truly needy. Funding for transportation and education could be cut to accommodate rising Medicaid costs, but if that is not enough, I believe benefits to the truly needy will suffer or taxes will be raised. You should know, according to the Kaiser Family Foundation, Missouri already spends more on Medicaid per enrollee than 42 other states. Medicaid devours nearly 40 % of the state budget ― more than education, transportation or public safety. The Foundation for Government Reform estimates the increased cost of Medicaid expansion at nearly $350 million per year. Every Missourian should ask where the money for a massive expansion of government spending will come from.

It’s my opinion Medicaid expansion represents a massive windfall for big city hospitals and, contrary to what proponents claim, promises no help for our rural hospitals, which are often suffering already. A study by the Foundation for Government Reform indicates hospital closures in Medicaid-expansion states are not different than in the states that have expanded. Any benefits that accrue usually go to the big city hospitals. If you look up who is funding the expansion proposal, you will see that it is largely big hospitals and labor unions, not the average taxpayer. But as taxpayers, we will foot the bill.

Finally, Missouri Right to Life predicts a significant increase in abortions with the expansion of Medicaid to able-bodied adults. Please vote “no” on Amendment 2 in August.

Thank you for reading this legislative report. You can contact my office at (573) 751-2108 if you have any questions. Thank you and we welcome your prayers for the proper application of state government.