Jeff Fox on business: Chambers support Missouri Medicaid expansion

Staff Writer
The Examiner
The Examiner

The Independence Chamber of Commerce has added its voice to those in favor expanding Medicaid under the program known in Missouri as MO HealthNet. The Blue Springs Chamber of Commerce has supported the concept for several years.

The Missouri Chamber of Commerce and Industry also has come out in support of the proposal going to the voters Aug. 4. Health associations and first-responders organizations also have endorsed the ballot initiative.

Thirty-seven states have already expanded Medicaid coverage, but the Republicans who control the Missouri General Assembly for years have refused to give the idea a full and fair discussion, let alone a vote. They argue the state cannot afford it and that spending will be cut elsewhere, singling out – as always – education.

But a study commissioned by the Missouri Foundation for Health says that’s flat wrong. State spending on Medicaid would actually go down, thousands of decent-paying jobs would be created, and the state would get a boost in economic growth, the study says.

Right now a person making more than $17,236 – $8.28 an hour – gets no Medicaid in Missouri. Still, In Jackson County, 29.6 percent of adults with incomes below that level have no health insurance, according to the Missouri Budget Project.

That $17,236 is 138 percent of the federal poverty level. Congress wanted states to add everyone with incomes below that level to Medicaid when it passed the Affordable Care Act more than a decade ago. About 230,000 people in Missouri – most of them employed – would get health insurance under the plan if voters say yes.

The federal government would pick up 90 percent of the cost of adding people to MO HealthNet, and Washington would cover some costs the state is now incurring. These are taxes Missourians are paying now – and have for years – but are being sent to other states.

The Missouri Foundation for Health study says “while total spending will rise, the state share will fall and be replaced with federal funding. This allows the state government to reallocate that portion of its budget to spending in other areas” – $72.4 million in 2022 and $1.11 billion by 2026.

The study also says the state would gain 8,654 jobs in 2022, rising to 26,364 added jobs in 2026. That includes 1,135 new jobs in Kansas City in 2022, rising to 3,394 in 2026. Many of those jobs are in health care, but the majority are elsewhere – construction, retailing, local government – created by health-care growth.

Eight out of every nine of those jobs would pay $15 an hour or more. That’s better than average for the new jobs being created in Missouri at the moment.

It adds up to a $2.5 billion bump to the state’s economic output product by 2026, the study says.

Economic snapshot

Some recent data points for the area and state economy:

• Missouri has lost 262,000 jobs, out of a workforce of just more than 3 million, since the beginning of the pandemic, according to the Creighton Economic Forecasting Group at Creighton University. That group says it sees slight gains in jobs in the state in the months ahead. It says new orders, sales and inventories are modestly strong.

• The state of Missouri says general revenues for fiscal year 2020, which ended June 30, were down 6.6 percent from the year before, falling to $8.93 billion. That’s about one-quarter of all state revenues. Individual income taxes are the biggest part of general revenues, and they fell 9.1 percent. Sales taxes were up 1.8 percent.

• Large parts of the economy slowed from mid-March to early May thanks to stay-at-home orders, but home construction has pushed ahead. The building of apartments and single-family homes in the metro area has fallen two years in a row, but the first few months of 2020 have been up. The Home Builders Association of Greater Kansas City says permits for single-family homes are up 28 percent through May.

Eastern Jackson County, however, is down 1.6 percent. But apartments are helping to offset that. No city in Jackson County issued a single permit for multi-family space in May – except Lee’s Summit with 273. That alone is the biggest reason multi-family housing permits are up 35 percent so far in Eastern Jackson County.

Jeff Fox is The Examiner’s editor. Reach him at or @FoxEJC.