Medicaid ensures that children with an autism spectrum disorder are able to see a therapist who can respond to their shifting needs. It helps pregnant women get the ultrasound that they need to deliver healthy babies. And, it allows seniors to live safely in a nursing home.

Plans being debated in Congress to repeal and replace the Affordable Care Act would have enormous implications for these and the nearly 1 million Missourians like them who get their health care through Mo HealthNet, our state’s Medicaid program. It would also put our state’s budget at risk.

Medicaid has always operated as a partnership between the federal government and the states. Each state pays a portion of the patient’s medical bill, with no limit on spending. For every dollar Missouri spends on coverage, the federal government provides $1.72 – a great deal for the state.

Both the Senate proposal and the House-passed health care plan would dramatically alter this partnership by capping the federal contribution. As a result, over time, the federal share of funding would shrink significantly, forcing states to choose whether to cut benefits or eligibility, raise taxes or cut other parts of the budget.

This is of grave concern to members of Missouri Health Partnership. Our coalition of advocates, providers and organizations has come together to support the health and behavioral health safety net for Missourians.

Medicaid plays a vital role in the health of our state, affecting residents in every single county. Medicaid provides a lifeline for one of every 12 seniors, one of every four Missourians living with a disability and two of every five children. Medicaid covers almost half of all births in the state, and it pays for almost two-thirds of nursing home care.

What’s more, Medicaid is critical to the infrastructure that serves us all – especially in rural areas. The health services provided through Medicaid create quality jobs and help hospitals and clinics to stay open, serving all Missourians.

More than 38.8 percent of Pemiscot County residents rely on health coverage through Medicaid. In Pettis County, 23.2 percent are covered, while 21.2 percent in Lawrence County and another 20.5 percent in Buchanan County. (See the complete list of counties below)

The current system of matched funding from the federal government provides security for these Missourians and for our state. Under this structure, Missouri can be sure that the federal contribution will increase if costs increase due to epidemics or innovation in health care. The new structure would leave Missouri few options to respond other than cutting vital health services.

We already can see economic forces at play. Gov. Greitens announced June 30 that he was reducing the reimbursement rate for Medicaid providers by $12 million and withholding another $60 million earmarked for the Department of Social Services, the agency that oversees MO HealthNet, due to lagging state revenues.

While these restrictions could be restored if the state’s finances improve, they are especially concerning when put in context of the broader context of health care reform being debated in Washington.

A recent analysis by the Urban Institute found that within the first 10 years of implementation, Missouri would face increased costs totaling $3 billion – an amount that is more than double the amount of state general revenue used to fund Medicaid in the 2017 state budget year.

Missouri already has some of the strictest Medicaid eligibility criteria in the country. It would be next to impossible to cut Medicaid without impacting kids, seniors, pregnant women and people with disabilities in all of Missouri’s 114 counties.

We call on Missouri’s Senators Blunt and McCaskill to work together to find a real solution to health care that serves all Missourians. Meanwhile, Missouri’s congressional delegation should reject the proposed changes to Medicaid funding. They put our most vulnerable citizens and our state budget at risk.

Amy Blouin

Executive Director

Missouri Budget Project

Jen Bersdale

Executive Director

Missouri Health Care for All

On Behalf of the Missouri Health Partnership

The Missouri Health Partnership is a coalition of advocates, providers, and organizations that have come together to support the health and behavioral health safety net for Missourians. The Missouri Health Partnership believes that it is vital to invest in a strong community health and behavioral health safety net, both to save lives and to save money.

Editor’s note: The percentages of populations from area counties reliant on Medicaid are as follows: 

Marion – 21.5 percent

Lewis – 14.4 percent

Shelby – 19.2 percent

Monroe – 17.2 percent

Ralls – 12.9 percent