01.29.21
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Monday, MHA released recent polling data on Missouri voters’ attitudes toward Medicaid expansion and implementation. The survey included very good news. Support for Medicaid expansion implementation is strong and seems to be growing, even among those who did not support the measure in August 2020.
Wednesday, Gov. Parson presented his vision for 2021 in the annual State of the State address. In addition to announcing support for several important components of our agenda, and heaping praise on hospitals and health care workers for their hard work during the COVID-19 response and recovery, he included Medicaid expansion implementation in his executive budget recommendation.
Although the Missouri House and Senate certainly will have their word on expansion funding, this is a very positive first step. I will not outline the details here, as we’re holding member briefings on the full agenda beginning today. However, the announcement — coupled with comments from Missouri Budget Director Dan Haug that expansion would not have a negative effect on other budget priorities in the 2021-2022 budget — provided the fiscal groundwork for implementation.
There’s still a lot of work to do. The funding details matter and could change in the legislative process. However, Parson’s recommendation is a good framework and will provide opportunity to build on some of the program management changes that will allow the state to address the sustainability of the program over time. It is clear from both Parson and Haug that they are less concerned about the coming budget than the years beyond. Our ongoing work with Health Management Associates, who produced a landmark report last year that showed how three other politically conservative states managed their expansion efforts, has and will continue to inform these efforts.
What the new opinion research tells us is that 88% of voters believe it is lawmakers’ duty to implement expansion. At the same time, four in five Missourians think Medicaid expansion is the right thing to do. When participants were presented with the statement, “Missourians voted to expand Medicaid because it will ensure health care coverage for the up to 230,000 residents who earn less than $18,000 a year for a household of one, including many working women and veterans, and it is important for the legislature to listen to the will of voters and implement the expansion and make sure hardworking Missourians have access to quality health care,” 81% agreed.
Survey participants strongly supported expansion’s influence on rural health, protecting the economic value of health care in their communities and the opportunity it provides for hardworking, low-income families. And, the appeal is broad-based, with two-thirds of individuals identifying themselves as independents favoring expansion, and a majority of Republicans — 56% to 38% — favoring implementation.
Missouri has more than 6 million residents, approximately 4.3 million voters and 197 state lawmakers. The voters voiced their support in August. That support seems to be growing. This week, Parson’s budget recommendation validated his commitment to the voter’s choice. Work remains to design an implementation that is both sustainable and produces value. That’s our goal.
Let me know what you think.
Herb B. Kuhn
MHA President and CEO
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