Vote yes on Amendment 2 on August 4

On August 4, Missouri residents will have the opportunity to vote yes on Amendment 2, which would expand Medicaid for approximately 230,000 Missourians. Access to Medicaid would allow individuals to receive timely preventative and emergency care and not delay life-saving treatments.

Since President Trump took office, the number of uninsured increased nationwide. Per U.S. Census data, Missouri’s uninsured rate was 13% in 2013 and fell to 8.9% in 2016, but in 2018 it rose to 9.4%. Missouri and a handful of other states refused to expand Medicaid, leaving millions of dollars of federal funds on the table.

Low-income populations are disproportionately affected by cardiovascular disease. Therefore, having Medicaid provides them access to providers, cardiac tests, and medications. For example, delaying treatment for an acute stroke can result in significant disability or death. With insurance, individuals can see their primary care provider regularly to discuss ways to reduce their risk of strokes and heart attacks. In 2018, 48% of the U.S. adult population had at least one heart-related condition. 

About a year ago, a patient presented to the clinic for a routine visit to discuss her diabetes and high blood pressure. She happened to mention that she had been feeling more fatigued lately, unable to complete tasks as before. Due to her extensive risk factors for cardiovascular disease, I recommended that she proceed with further testing, such as a stress test. The stress test was abnormal. The patient underwent a cardiac catheterization, which showed multiple blockages in her arteries. As a result of the significant arterial blockages, the patient required surgery, a coronary artery bypass graft. Such testing and the subsequent multiple doctor’s visits could not have been accomplished without health insurance.

Voting yes on Amendment 2 also allows our Missouri neighbors to have access to cancer screens such as colonoscopies, mammograms, and pap smears. Colorectal cancer is the third leading cause of cancer-related deaths in men and women in the United States and is expected to kill around 53,000 people in 2020. Compared to all other racial groups in the U.S., African Americans have the highest incidence and mortality rates of colorectal cancer per the American Cancer Society. Therefore, early detection with a colonoscopy or other screening modalities are recommended. Average cost of a colonoscopy is approximately $3000. Imagine having to pay that fee without insurance.

Disparities also exist in breast cancer diagnosis and treatment. Breast cancer is the second-leading cause of cancer deaths in women. Black and white women are diagnosed at the same rate but black women are more likely to die of breast cancer. Lack of insurance and lack of access to the most current treatments are some of the many reasons for this inequity. Having health insurance through Medicaid would allow women to have their recommended mammogram on a regular schedule. Early detection is key to survival.

Furthermore, Medicaid expansion also provides a lifeline to many of our rural communities. Several Missouri rural hospitals have already had to close as a result of budget shortfalls. Residents of those communities sometimes have to drive hours just to see a specialist. 

On August 4, let’s support our fellow Missourians and vote yes on Amendment 2 to expand Medicaid. 

Denise Hooks-Anderson, M.D., FAAFP, is associate professor at SLUCare Family Medicine and the medical accuracy editor of The St. Louis American. She can be reached via email at: yourhealthmatters@stlamerican.com.