Two of the first statistical trends to emerge during the earliest months of the COVID-19 pandemic was that African Americans were contracting the virus at higher rates and dying more frequently.
Conservative legislators leaned on their racist, deceptive message that still appeals to their political base. ‘It’s those people in the city that need Medicaid, not us. They want something for free.’
A major determinant is the lack of adequate health care in some Black communities, which is why the Missouri voters initiative to expand Medicaid in August 2020 was vital to more positive health outcomes in the future.
Rather than lend its support to immediate expansion, the state’s Republican supermajorities in the House and Senate continued to do any and everything possible to overturn the voters’ expressed will.
In April, House Republicans removed $1.9 billion allocated for the July 1 Medicaid expansion. The Senate followed suit.
Gov. Mike Parson, who initially said he would support the will of the people, took no action to return the Medicaid funding to the budget. This effectively withdrew the state’s support from expansion of Medicaid. He and Republican legislators willfully ignored 53.25% of voters that favored expansion.
These ignominious actions did not prevail in Missouri courts. When their callous and politically self-serving ploy was legally rejected, the next shameful move was to stall the inevitable.
Conservative legislators leaned on their racist, deceptive message that still appeals to their political base. ‘It’s those people in the city that need Medicaid, not us. They want something for free.’
The truth is that Medicaid expansion will serve the under-insured residents of rural Missouri as much or more than people in the metropolitan areas of the state.
Again, the pandemic data illustrates why adequate health care options are important to every county in Missouri.
According to the Kaiser Institute, since the pandemic began, about 1 in 434 rural Americans have died from COVID-19, compared with roughly 1 in 513 urban Americans, the institute’s data shows. “And though vaccines have reduced overall COVID death rates since the winter peak, rural mortality rates are now more than double that of urban ones — and accelerating quickly.”
The Institute concludes that rural residents without health care options comprise many of these deaths.
Thankfully, Republican state legislators failed in their attempt to derail, then slow Medicaid expansion. Medicaid applications began being processed on Oct. 1. More than 17,000 Missourians have applied, and up to 275,000 are now eligible.
Obviously, most of these Missourians are not people of color and do not reside in major cities and adjacent suburbs. These are just two of the fallacies championed by Republicans here, and nationally, to delude their loyal base voters.
The saddest part of that scheme is that these politicians know that they were pulling the wool over many of their constituents’ eyes. Somehow, they were able to convince them to vote against Medicaid expansion, something that would serve their communities and rural hospitals.
A patently false reason Republicans gave for their behavior was that Missouri could not afford Medicaid expansion, ignoring the fact that the federal government would financially support it here just as it has in dozens of other states – including ones with Republican-dominated legislatures.
On Monday, the U.S. Department of health and Human Services announced that Missouri will receive an estimated $968 million for expanding Medicaid to individuals making no more than about $178,000 a year.
“Hundreds of thousands of Missourians can now gain the peace of mind of having health coverage through Medicaid. This is a win for all Missourians who have fought long and hard to gain their rightful access to quality health insurance made possible through the Affordable Care Act (ACA),” HHS Secretary Xavier Becerra said.
That statement is important because it exposes one of the root causes of Republican success at delaying Medicaid for a decade. The ACA was passed strictly along party lines in 2010 and was then cynically dubbed “Obamacare” by Republicans. This became a dog whistle that led to huge losses for Democrats in 2012 and subsequently their loss of control of Congress. Defying President Obama’s historic legislation was more important to the state GOP than the health and well being of the people that put them in office.
This is shameless, but not surprising, behavior by Republican leaders of the state of Missouri, and the remaining red states that deny health coverage to the most needy. They exploit grievance and fear to seduce their voter base into supporting self-defeating policies. Fortunately, despite the cynical, unrelenting resistance from Missouri Republicans, more than 275,000, who are mostly the working poor, will belatedly have access to a basic human need, health care.