State Rep. Tommie Pierson Jr.

On July 30, 1965, Medicaid was born with the passage of Title XIX of the Social Security Act but the struggle began in 1935, with President Franklin Roosevelt’s social security program. Conservative white southerners vehemently opposed this helping hand, fearing that the tax dollars provided to African/American workers would change their economic dependence and plight. This opposition ensured that the 1935 Social Security Act excluded domestic workers and agricultural laborers, the majority of whom were African-American.

In 1964, Democratic President Lyndon Johnson fought for new federal assistance including Medicaid and Medicare. While the president faced significant conservative Congressional opposition, the recent Democratic electoral victories gave public health advocates an opportunity to establish a federal health care program.

Forty-six years later, President Barack Obama sought to fix this unequal, unjust system and signed into law the Patient Protection and Affordable Care Act. For the first time, low-income American adults would be guaranteed access to health care coverage under the law no matter where they lived in America. Once again, however, conservative Southern states fought back, challenged the Affordable Care Act’s Medicaid expansion in court — and won. The conservative Supreme Court upheld Medicaid expansion in 2012 but made it voluntary by state, thus restoring the inequality engrained into Medicaid’s establishment.

African Americans live with chronic conditions such as diabetes, heart disease, and HIV/AIDS at far greater rates than other racial groups. African Americans have higher uninsured rates than whites (7.5%) and Asian Americans (6.3%) according to the National Center for Health Statistics. More than one-quarter of uninsured adults who would be eligible for Medicaid if all states expanded are people of color. The Kaiser Family Foundation found that the coverage gap in states not expanding Medicaid disproportionately impacts poor, uninsured African-American adults.

A decade after the Affordable Care Act’s passage, a disproportionate majority of African Americans are without coverage, in large part because of conservative states, like Missouri, that refuse to expand Medicaid. Missouri is one of 14 states that has yet to expand Medicaid.

Various studies suggest that states with expanded Medicaid coverage have a 6% lower rate of opioid overdose deaths, along with infant mortality rates that are lower than non-expansion states. Unfortunately, states that haven’t expanded Medicaid have failed to realize the full potential of expanded coverage which goes beyond health benefits. Additionally, the Missouri Foundation for Health suggests economic impacts of an increase of 16,000 jobs as well as a $1.6 billion jolt to our state’s Gross Domestic Product.

As voters, we have an opportunity to change the future of our healthcare, and I am running for state Senate to bring healthcare solutions to Missouri and specifically North St. Louis County. When so many people lack access to affordable healthcare, and those with health insurance can’t afford their premiums, it’s time for change.

Join me in voting for Missouri Amendment 2, the Medicaid Expansion Initiative, on Tuesday, August 4. A yes vote on Amendment 2 will bring billions of Missouri tax dollars back into our state, closing a huge coverage gap so that 300,000 of our low-income neighbors, most of whom are working, will finally get health care that has long be denied. Let us fix this unequal and unjust system by passing Medicaid expansion in Missouri.

Tommie Pierson Jr. represents the 66th District in the Missouri House of Representatives and is a candidate for Missouri Senate in the 13th District as a Democrat on the August 4 ballot.

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