Jackson County legislators have lent their support to an expansion of the Medicaid program in Missouri, a move advocates say would extend health coverage to more than 200,000 Missourians – most of them working adults – who currently lack it.

Advocates are using the petition process to get the issue on the ballot in November 2020. “Missouri is one of the handful of states in the nation that’s refused to expand their Medicaid program to cover more people, particularly adults, that was expected to happen under the passage of the Affordable Care Act,” Legislator Crystal Williams, D-Kansas City, said as legislators heard testimony last week. “As we have continued to not provide that coverage … it’s become apparent that we as citizens have to take a nonpartisan approach and take it into our own hands to ask the people of the state of Missouri to assist us in passing this.”

Jessica Hembree, policy officer of the Health Forward Foundation, said a lack of health insurance is forcing many to choose between paying medical bills and paying for other essentials such as housing.

“One of the most critical barriers to health access is the lack of health insurance in our community,” she said. “So we have long supported expanding access to the Medicaid program. … We believe the time is right for the state of Missouri to consider this issue by a vote of the people.”

She also noted that states that have expanded Medicaid have seen a growth in health-related jobs and cited a study suggesting Medicaid expansion would save the state $30 million a year.

Melissa Robinson, president of the Black Health Care Coalition, said her group served

613 people last year, 30 percent of whom lacked health insurance. That lack of insurance often means people miss out on screening and treatment for controllable health conditions such as hypertension and diabetes, which left untreated can lead to worse conditions.

“So individuals in our community are dying unnecessarily because they don’t have access to care,” she said.

Of the patients seen last year, she said, 45 percent had hypertension, 21 percent had diabetes – and 17 percent had both. Also, 64 percent had three or more risk factors for cardiovascular disease.

“Again, access to care will help to prevent that,” she said.

Lack of basic, preventive care also means people get sicker and often end up in the ER – a far more expensive option for hospitals and the taxpayers who often underwrite that care, advocates have long pointed out.

“Bottom line,” Williams said, “is that well people are way less expensive than sick people.”

An expansion of Medicaid was intended as a key part of Obamacare. The federal government has picked up most of that cost. But Missouri and 13 other states have not done so, and advocates claim that has contributed to a string of rural hospital closures – nine in seven years – in the state. Republican leaders in the Missouri General Assembly have refused to allow Medicaid expansion to advance far or come up for a vote.

Williams said the petition effort is bipartisan. The County Legislature seldom votes along strictly partisan lines, but this vote did fall that way. All seven Democrats voted yes. Legislator Theresa Galvin, R-Lee’s Summit, voted no, and Jeanie Lauer, R-Blue Springs, was absent.