I am writing in response to Dave Spiering’s arguments (Globe, May 31) against Medicaid expansion in Missouri.

Yes, there is a cost for Medicaid expansion to the state. The cost would be paid 90% by the federal government and 10% by the state. Opponents say that the 90-10 split won’t last and Missourians will end up paying the whole cost. However, the law that authorizes Medicaid expansion requires this federal cost-sharing to remain at this 90-10 level in perpetuity. Certainly, other federal-state partnerships exist under this model. For instance, much of Missouri’s road costs are based on a 90-10 split, and it has been this way for quite some time and seems to be working well.

Further, Spiering argues that Medicaid expansion will ultimately require residents to trade off tax-related services such as road maintenance, education and even Medicare in order to pay its 10% share of the cost. However, many entire countries such as our neighbors in Canada provide universal health care to all their people, yet they also somehow find ways to maintain roads, educate their children and help seniors in retirement.

The sad fact is that in the past 10 years, Missouri’s General Assembly has refused to adopt Medicaid expansion, and as a result, upwards of $1 billion has been left on the table to be distributed to those states that did adopt the expansion. And yes, we are being taxed as if we had the program.

Further, in the past 10 years, we have lost at least 10 rural hospitals in Missouri. These hospitals closed because they couldn’t afford to stay open. They closed because many people who needed and received medical attention had no way to pay for it. As a result, all of the folks who depended on those community hospitals are out of luck regardless of whether they have health insurance.

Then, there’s that old saw that only the “deserving poor” should be helped. Sorry, but that dog won’t hunt. Refusing services to a whole class because some might “abuse” the service (in the example used by Spiering, going to the emergency room when a visit to a private physician would do is system abuse) is ridiculous — and heartless. Indeed, other states that have expanded Medicaid have seen a shift to more preventative care as opposed to the last resort use of emergency rooms to treat conditions that have gone untreated for too long.

If a person can’t determine if an appointment with a doctor or a visit to the ER is most appropriate, that’s an education issue, not an eligibility issue.

With Medicaid expansion, if you are a single adult and your income is less than $18,000 a year (that’s $8.65 an hour for a full-time wage earner), you would be eligible for health care coverage. Period.

Finally, Spiering seems to argue that we shouldn’t expand health care to include low-income adults because medical costs are increasing each year. He asks, “Did extending prescription drug coverage under Medicare a decade and a half ago make drugs more affordable?” The answer is: Yes, it did.

Thousands upon thousands of people who are older than 65 have access to drugs they would not be able to afford but for Medicare. Are drug costs continuing to rise? Yes, they are. But that’s not because of Medicaid expansion. Nor is it because of a failure of the Affordable Care Act. It is because Congress has absolutely refused to give the federal government the authority to negotiate drug costs with pharmaceutical companies.

Will Medicaid expansion in Missouri benefit its residents? Yes, it will. Not only will more than 230,000 Missourians gain access to health care, but community health centers will be able to remain open because they will have access to funds needed to continue to serve the community.

I’m voting in August in favor of Medicaid expansion, not because it solves all the problems of our health care system but because it is a step in the right direction for Missouri.

Patricia O’Roark is a resident of Carl Junction.

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Patricia O’Roark: Medicaid expansion the right step for Missouri – Joplin Globe