TAILIEUCHUNG - THE MEDICAID EXPANSION IS GOOD MEDICINE FOR MISSOURI

This programmatic update, while not presenting new guidelines, reviews the currently recommended Options A and B, discusses the rationale for Option B+, and provides an update from WHO indicating and weighing preferences as much as possible among the range of options. This update summarizes key issues that need to be addressed in field settings and in national programmes. It also highlights evidence gaps that need to be addressed to build a base for future revision of guidelines. | THE MEDICAID EXPANSION IS GOOD MEDICINE FOR MISSOURI January 2013 Joel Ferber Director of Advocacy Legal Services of Eastern Missouri 4232 Forest Park Avenue St. Louis MO 63108 The work on this paper was funded by a grant from the Missouri Foundation for Health. Missouri has an unprecedented opportunity to improve the lives and health of its residents by adopting the Medicaid expansion of the Affordable Care Act ACA now a state option after the Supreme Court s decision in June 2012. The Governor has announced that he will include funding for the Medicaid expansion in his upcoming budget request. The ACA enables states to expand Medicaid coverage to 138 of the federal poverty level 15 415 for an individual or 26 344 for a family of three . Implementing the Medicaid expansion in 2014 will improve access to health care and health outcomes for nearly 260 000 low-income Missourians who are currently left out of Missouri It will also have significant positive ramifications for the state s economy while a failure to implement will have a clear adverse impact. This paper analyzes key aspects of the State s decision regarding this important state option. The Supreme Court s Decision and the New State Option On June 28 2012 the Supreme Court upheld the constitutionality of the ACA and the controversial requirement that most individuals have health insurance the individual mandate .2 The Court however also did what no district or appellate court had done finding that the ACA s provision allowing the federal government to remove all federal Medicaid funding for states that do not expand Medicaid coverage to 138 of the federal poverty level was unconstitutional even though the Medicaid expansion itself is The Court treated the ACA s expansion of the Medicaid program as if it were a new program and decided that the federal government could not condition funds for the existing Medicaid program on participation in the new program created by the ACA. .

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