Medicaid expansion will benefit patients, state economy

As a practicing physician of 36 years, there's nothing worse than seeing a patient with a late-stage illness that likely could have been prevented if only they had come to see me earlier -- but didn't, because their job doesn't offer insurance, and they can't afford basic coverage on their own.

One such patient came to me with brain metastasis from lung cancer. Had he come in six months earlier things would've been very different.

This hard-working gentleman, who had no insurance, put off going to the doctor because he couldn't afford to. Medicaid ultimately helped him, but that was after-the-fact, to cover his hospice care.

I also treated an infant born with Down syndrome whose parents made about $400 a year too much to get Medicaid services for their child.

They struggled through the years to provide appropriate physical, occupational and speech therapy and had to pay the hospital and doctors' bills for stomach and major open-heart surgeries (all in the ï¬rst year of life) out of their own pockets. Only recently, on their daughter's 18th birthday, did they finally get Medicaid services for her.

The cruel reality is that our state has left more than 230,000 hardworking Missourians without access to affordable healthcare for far too long. The good news is we can help end the debate over lifesaving care versus finances for these folks -- my patients, your friends, family and neighbors -- by passing Medicaid expansion in the November general election.

The status quo is hurting my patients' health, hurting our state's economy and worsening this country's rural health care crisis -- an epidemic that's hit especially hard in Southeast Missouri, home to five of the 10 rural hospitals to shutter in our state in recent years.

Study after study from the 36 states to approve Medicaid expansion so far shows that Medicaid expansion generates increased economic activity and budget savings, with no overall increase in state general revenue expenditures.

Show-Me Institute fellow Andrew Wilson's criticism ("The myth of 'free' Medicaid expansion," Feb. 13 op-ed in the Southeast Missourian) of a Washington University study on the fiscal impact of Missouri Medicaid expansion is an example of not seeing the forest for the trees.

Current Medicaid recipients who are considered permanently and totally disabled wouldn't be "reclassified." Rather, the WashU projections rely on conservative estimates based on a steady flow of new enrollees over the course of several years.

Down the road in Arkansas, savings from Medicaid expansion allowed that state to cut its income taxes, providing more than $100 million in annual relief to middle-class taxpayers, according to an analysis of Medicaid expansion in Arkansas, Indiana and Ohio. The same report found that expansion led to more than 19,000 new jobs in Louisiana and 31,000 new jobs in Colorado.

As a doctor, I don't often write in to comment on the news of the day or get involved in campaigns. But I support this ballot measure because I know preventative care saves lives.

No one should have to choose between paying for lifesaving care and paying their mortgage. Billions of our tax dollars that should be coming home from Washington but are not.

Myself and other doctors, nurses, patients, hospital leaders, business owners and voters from across the state have joined together to support the Healthcare for Missouri campaign (www.healthcareformissouri.org) to let voters decide what's best when it comes to our health.

The ballot measure would give Missouri voters the chance to decide for themselves on Medicaid expansion. In just a few months, Healthcare for Missouri has already collected more than 75% of the 172,000 signatures needed to put Medicaid expansion on the statewide ballot in the November general election, with an early May signature submission deadline.

In addition to Arkansas, our neighbors in Illinois, Iowa, Kentucky and Nebraska have also opted in on Medicaid expansion. A 2020 Medicaid expansion ballot initiative is also on target in Oklahoma, where volunteers have collected a record number of signatures, and in Kansas, where a bipartisan compromise has set the state for a deal.

The sad truth is we're already paying for Medicaid expansion. Missouri communities are just not receiving any of the benefits from doing so, and that needs to change.

It's just that simple.

Dr. Sarah Aydt is an internal medicine specialist and board-certified pediatrician at Cape Family Practice.