Physicians and health care advocates opposed to a ballot measure that would eliminate Missouri’s income tax and could lead to higher sales taxes are warning that the proposal could increase health care costs for Missouri families, seniors and patients.
Amendment 5, which will appear on the Aug. 4 ballot, would gradually reduce and eventually eliminate the state income tax if certain revenue-growth benchmarks are met. The proposal would also give lawmakers broader authority to modify sales taxes and other revenue sources to offset the loss of income tax revenue.
Supporters of the measure, including Gov. Mike Kehoe, say eliminating the income tax would allow Missourians to keep more of their earnings while strengthening the state’s economy.
The physicians and advocates said replacing income tax revenue could eventually lead to higher costs for goods and services, including health care. They said their concerns center on how rising costs can affect patients’ ability to obtain care, fill prescriptions and seek preventive treatment.
“As physicians, we see every day what happens when health care becomes unaffordable,” said Dr. Priya Pal, a physician-scientist specializing in HIV research. “People delay appointments, skip medications, postpone screenings and arrive sicker than they otherwise would have.”
Pal said future tax changes could make health care less affordable for some Missourians.
Dr. Christian Hendrix, an internal medicine physician training in infectious diseases and critical care medicine, said the proposal could make it harder for patients to afford doctor visits, medications and other necessities.
“If this bill will make affording doctor visits and medicines harder for patients, while having the ultra rich pay less to help their neighbors, this is nothing more than a wealth transfer from everyday, working people to billionaires,” Hendrix said.
Leslie Ortbals, a health care advocate who lives with multiple chronic illnesses, said families already struggling with medical expenses could face additional financial pressure if everyday costs rise.
“If Amendment 5 passes and makes health care and everyday necessities more expensive, it won’t be the politicians making these decisions who bear the consequences,” Ortbals said. “It will be people trying to afford a prescription, seniors stretching a fixed income, parents caring for children with disabilities and young families like mine trying to build a future while managing the rising cost of simply getting by.”
The Missouri Budget Project, which opposes the amendment, has argued that replacing income tax revenue would likely require higher sales taxes or expanding sales taxes to additional goods and services. The organization estimates that between 60% and 80% of Missourians could see a net tax increase under a system that relies more heavily on sales taxes.
Amendment 5 has been the subject of court challenges over its ballot language. Missouri appellate judges recently ordered revisions to the summary language voters will see but allowed the measure to remain on the Aug. 4 ballot.