Yinka Faleti

There is no question that communities of color in our nation face significant health disparities. African Americans have higher rates of cancer, diabetes, heart disease and maternal mortality than their white counterparts. The life expectancy of an African American is almost four years lower than the average.

Disparities are even more glaring in Missouri, where the life expectancy for African Americans is 5.2 years shorter than for whites. African American mothers in the Show-Me State are more than twice as likely to deliver very low birth weight newborns (VLBW) compared to white mothers, and African American newborns in Missouri are about 60% more likely to be born prematurely than white newborns.

These statistics are alarming, and they represent centuries of systemic racism baked into medical practice and public health in the United States. We need radical change in the way our medical students are taught, the way our doctors administer treatment to African Americas, and the way we collectively take care of the health and well-being of our communities. This change will require a bevy of political, cultural and medical changes to be effective, and many of these changes won't be made by the general public. But one major change that can help Missouri move in the right direction, and is achievable only if the general public approves it, is Medicaid expansion.

On August 4, Missourians across the state will head to their polling places to vote in our state's primary election. It’s not just candidates on the ballot, though. We will also be voting on a constitutional amendment. Amendment 2, if passed by the people, will expand Medicaid in Missouri, bringing in a 90% federal match to administer and expand our state's Medicaid program. That could mean more than 226,000 Missourians will finally have affordable healthcare. Of that number, roughly 36,000 more African Americans would have access to much-needed healthcare.

From the Center on Budget and Policy Priorities, we know Medicaid expansion improves diabetes and hypertension control, increases early-stage cancer diagnoses, and shores up hospital budgets, especially in rural hospitals. We also know that, in states that have expanded Medicaid, low-income families—the main benefactor of Medicaid expansion—see increased access to a personal physician, more annual check-ups, and better long-term treatment for chronic conditions, such as diabetes, heart disease and more. Researchers also found that Medicaid expansion is significantly associated with lower maternal mortality by 7.01 maternal deaths per 100,000 live births. This type of access to care can save lives—especially in Missouri's African American communities, which experience the worst health outcomes of any group.

Medicaid expansion is also good for our state's pocketbook. Analysts at Washington University in St. Louis predict that Medicaid expansion in Missouri is likely to be approximately revenue-neutral, with the potential for cost savings in 2020 and with increased cost savings likely over the 2020-2024 time horizon. This means that Missouri's budget won't increase, but our state's revenue has the potential to increase by somewhere around $39 million in 2020 alone when Medicaid is expanded in the state.

Expanding Medicaid in Missouri is the best option for everyone in our state, but especially for communities of color. On August 4, voting "Yes" on Medicaid expansion means you are helping to move our state in the right direction—toward a future with equitable and effective health outcomes for each and every Missourian, no matter their zip code or race.

Yinka Faleti is a graduate of the United States Military Academy at West Point, a U.S. Army veteran, and the Democratic nominee for Missouri Secretary of State. He is the former Executive Director of Forward Through Ferguson. Learn more at www.yinkafaleti.com.

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