Stephen Eisele

The real Medicaid work problem is not with low-income Missourians, but with the politicians in Missouri who won’t do their jobs.

What could you do with $5,000 in annual income, which is roughly $100 a week? Could you support a family of three? Could you afford your rent or electric bill? Could you pay for health insurance? In the Show Me state, that meager sum currently places you above the income threshold to qualify for Medicaid.

For roughly 300,000 Missourians, they earn too much to qualify for Medicaid, and yet not enough to benefit from the Affordable Care Act’s financial assistance to pay for health insurance in the marketplace, leaving them in a coverage gap that is difficult to escape.

Instead of joining the growing contingent of states across the nation – 36 and counting – in expanding access to a proven health insurance program, our elected leaders in Jefferson City are attempting to enact barriers to health coverage for our state’s neediest residents.

Bills filed and moving in both chambers of the Missouri General Assembly would impose reporting requirements on Medicaid and SNAP beneficiaries. At a time when Missouri is experiencing a significant budget shortfall, our government needs less red tape and bureaucracy, not more. It’s foolish to think that adding reporting requirements will do anything except cost our state more money, add more paperwork for everyone, and take health care away from Missourians.

Governor Parson expressed in his State of the State a desire to make Medicaid more efficient to save money and better accommodate our state’s residents – but these will have the opposite effect.

If we want to look at the devastating consequences these paperwork penalties have on real people, we need look no further than our neighbor to the south, Arkansas. Since implementing these reporting requirements last June, more than 18,000 Arkansans have lost needed health care coverage – and counting. Health care experts believe the losses are due in large part to the restrictive reporting requirements and efforts to inform beneficiaries – not a lack of effort by participants. Stripping away one’s health care because of bureaucratic requirements punishes those who are struggling to make ends meet while raising kids and dealing with ongoing health issues.

Due to Missouri’s extremely low eligibility levels – one of the lowest in the country – most participants can’t work more hours without losing their health insurance. If Missouri adds reporting requirements, low-income parents will be in an impossible situation – if they can’t prove they’re working, they’ll lose their coverage; if they work enough to earn more than $100 a week, they’ll lose their coverage.

Gov. Parson, Speaker Elijah Haahr and others have prioritized workforce development. To look for and keep a job, one must be healthy first. Punishing people who have lost a job, work seasonal or irregular hours, or work with changing schedules, should not have their access to medication or medical care put in jeopardy. This would only leave them sicker and less able to work in the future. 

The real Medicaid work problem is not with low-income Missourians, but with the politicians in Missouri who won’t do their jobs. It’s past time for lawmakers in Jefferson City to earn their salaries – and the taxpayer-subsidized health insurance we pay for – by seeking solutions to the health care needs of their constituents.

Representatives and senators in the Missouri General Assembly ought to stop erecting barriers to coverage, and instead look for ways to expand coverage and put the billions we send to other states back to work here in Missouri – now that’s a work requirement that makes sense.

In Ohio, three quarters of Medicaid expansion participants who were looking for work stated that Medicaid coverage made it easier to do so. Medicaid also works in other ways. Increasing health care coverage through Medicaid would give hard-working Missourians access to affordable health care. Healthier individuals lead to more stable families and stronger communities.

Missourians are common sense folk, and yet, skeptical people. Many decades ago, a legislator from our state implored his fellow politicians to “show me.” Today, the evidence is all around us. Work requirements don’t work.

The 100th Missouri General Assembly is one of historic significance. What could be of more significance to hundreds of thousands of Missourians than to work toward better health care for all? Let’s work together to move Missouri forward.

Stephen Eisele, 32, is a health care advocate living in Richmond Heights. He serves as board president, Missouri Health Care Action, and board member, Missouri Health Care for All.

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