Nimrod “Rod” Chapel Jr.

While Missouri sits on the sidelines of Medicaid expansion, far too many hardworking Missourians remain forced to choose between lifesaving care and putting food on the table.

Our state’s rural hospitals continue to shutter. And three dozen other states access the federal dollars we refuse.

Our state’s leaders are pitting politics against people. Fortunately, the ballot initiative process gives Missouri voters the power to make the changes that our elected leaders won’t.

And come November, it could be how the Healthcare for Missouri campaign wins sorely needed health coverage to more than 230,000 uninsured adults in the state through Medicaid expansion.

The Missouri State Conference of the NAACP, for whom I’m honored to serve as president, is among more than 150 groups so far to endorse the campaign since its fall 2019 launch. Hundreds more organizations are expected to join in the coming months.

This nonpartisan coalition transcends party politics, racial lines, the rural-urban split, and other labels that divide rather than unite.

Members of the clergy are among those leading the righteous charge, with faith leaders turning out in force at recent campaign events in places like Hannibal and Joplin.

As an attorney who represented the Medicaid 23 – a group of clergy arrested during the 2014 legislative session for praying in the Senate gallery as a protest in support of Medicaid expansion – this comes as little surprise to me. 

But beyond the moral imperative, Medicaid expansion makes fiscal and economic sense. Just look at some of the other voices at the table: the campaign coalition includes some of the state’s most powerful business voices, such as the St. Louis and Greater Kansas City Chambers of Commerce and the Civic Council of Greater Kansas City.

Washington University has pledged its support, as have statewide medical groups such as the Missouri Hospital Association, Missouri Primary Care Association, Missouri Nurses Association and major hospital systems from Springfield to St. Louis.

Thirty-six states have already taken this step, including five that border ours: Arkansas, Illinois, Iowa, Kentucky and Nebraska. None have changed course because implementation costs were too high.

On the contrary, dozens of research studies show that Medicaid expansion will not just save lives but also save taxpayers money.

One of those reports, released in late January is an analysis of Medicaid expansion in Arkansas, Indiana and Ohio – three states whose politics more closely resemble Missouri than any coastal outliers.

In Arkansas, savings from Medicaid expansion led to a state income tax cut for the middle class, the researchers found. Ohio, under Rep. Gov. John Kasich, gained more than $300 million annually from revenue and savings generated by expansion.

And Indiana, under then-Gov. and now Vice President Mike Pence, opted in early enough in 2015 to take advantage of a 100 percent federal match (Missouri’s match would be capped at 90 percent) “with no substantial impact on the state budget or general fund.”

Missouri could expect comparable benefits, the researchers from Health Management Associates concluded, with “savings and revenue opportunities that significantly exceed the state’s cost of implementation.”

The Missouri State Auditor estimates that Medicaid expansion will lead to as much as $1 billion in state budgetary savings, largely because new federal funds will be able to offset current state health spending in Medicaid, prison health, mental health and substance abuse treatment.

The numbers are in our favor. The need is obvious. The will is there – with an early May deadline, Healthcare for Missouri has already collected more than 75 percent of the signatures needed to get on the November ballot.

Rev. Wallace S. Hartsfield Sr., a Medicaid 23 member and the late pastor of Metropolitan Missionary Baptist Church in Kansas City, prayed that the hearts of our leaders would be softened. Even now, I can hear his voice saying, “Fight on!”

On Election Day this fall, we have to do what our legislators won’t, take our demands for basic healthcare and life-sustaining help and make them law. The NAACP will see you at the polls, but right now you can stand for dignity by signing the Healthcare for Missouri petition and supporting Medicaid expansion come November.

It’s time to let the people decide.

Nimrod “Rod” Chapel Jr. is president of Missouri State Conference of the NAACP.

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