Speeches & Commentary

Expanding Medicaid will have a positive impact on Missouri

Dear Washington University community,

So much has changed since November, when we first wrote to you about the campaign for Medicaid expansion in Missouri. Who could have predicted the health crisis precipitated by COVID-19 and the way it has exposed the very deep and long-standing national problems of health-care access that were targeted by the Affordable Care Act when it was first enacted in 2010? We are encouraged that we can now share the news that the campaign has succeeded in getting the Medicaid expansion initiative approved for a statewide vote that will appear on the August 4th ballot as Amendment 2.

We believe strongly in this campaign because of its potential to expand access to health care for Missouri residents who desperately need it. Right now, many adults living in poverty are simply not eligible for Medicaid and a large number are excluded from receiving federal subsidies to purchase private insurance. Most of these Missourians are working hard but are still unable to gain access to health care, a heartbreaking example of the kind of systemic inequity that works against those who are trying to improve their lives. What’s more, expanding Medicaid will have a positive economic impact on Missouri, creating jobs and returning federal dollars to our state.

This is the right move for the State of Missouri – especially at a time when more people will be out of work and needing assistance – and Medicaid expansion will have a tremendous impact on all disadvantaged Missourians. But it is also a critical step in our too-long journey toward a more just society on behalf of Black Americans, for whom racism is a public health crisis. There is a reason that the Forward Through Ferguson report included Medicaid expansion as one of its Signature Calls to Action to address the racial and social justice inequities that continue to affect our region. The past three months have shown in stark terms the consequences when members of our community have unequal access to health care but we must also continue to grapple with a reality in which, even before this virus arrived, residents of St. Louis ZIP codes separated by only few miles had up to an 18-year difference in life expectancy.

The racial health gap is staggering and so is the racial wealth gap. A recent study shows that the average Black family with children holds just one cent of wealth for every dollar held by the average white family with children. This gap is impossible to close without bold national policies that aim to build Black American wealth and we believe history will show that Medicaid expansion was the first such policy to address this in our country since the 1960s. And so we are bringing it to your attention again today and for the weeks to come. Many of us feel an urgency, a deep pressing need for long-overdue systemic change, and real change requires us to commit ourselves to local and national policies that will help bring about the world we wish to see. This will be part of our way forward toward equity and justice.

So, what can we do? We all should digest the extensive research conducted by experts here at WashU and elsewhere and, at a minimum, make sure you are registered to vote before the July 8th deadline to participate in the August 4th primary. The Gephardt Institute’s WashU Votes initiative has more information about voter registration. Talk to your own families and communities about this important vote.

Just imagine what could happen if the state were to use its additional resources to improve early education, which we know is a critical determinant of improving the chances of Black and poor families to participate in the American dream. Education and health go hand-in-hand, and Medicaid expansion could offer an opportunity to improve access to both. We owe it to our children to take this first step in the long journey of breaking the cycle of poverty and building a better future for everyone.

David H. Perlmutter, MD
Executive Vice Chancellor for Medical Affairs

Andrew D. Martin, PhD