Morning Edition; Jen Bersdale

It's Morning Edition on KRPS. 2020 was a year like no other in recent memory. That includes the passage of Medicaid expansion, Missouri. Joining us this morning is a person who led the fight for expanding Medicaid and Missouri, the Executive Director of Missouri Health Care for All, Jan Burstdale. Jan, thank you for joining me on Morning Edition. Thanks for having me. It's now middle of January 2021. Governor Mike Parsons been sworn in and the legislative session is now underway. So for those across Missouri watching Medicaid expansion unfold, where do we stand today? So it's really early in legislative session. There's a lot still to come including the governor's budget recommendations and then of course the budget work that the legislature will do. But right now, you know, we are certainly expecting that the legislature will honor the vote of the people, which as you noted was a sizable margin. And so yeah, the houses out of session right now, but when they are back, we expect that they'll start working on the budget and really get going on things. And so the first big deadline will be March 1st when Missouri has to have

our state plan amendment, basically the plan for how we're going to do this to the federal government. So I know we're all watching for that deadline. But right now, you know, we are certainly assuming that our legislators will do the right thing and implement this as well. And you brought up Governor Mike Parsons' state of the state speech. I believe that is taking place on January 27th. That's a Wednesday next week. And the reason I wanted to talk to you early in the process of this is that even if you just watch one year, you know how slow the Missouri legislation can work, especially during the coronavirus early on, it seemed that the Missouri legislative, both houses, the state Senate and the House, wanted to continue to meet in person. They didn't want to pass a law saying that they could meet online and vote in line. And here this week, we have the Missouri House out in the Missouri state Senate in. Do you think this, the slowdown will affect these dates or solid dates. They can't be pushed.

Can they? No, they're in the Constitution. So, you know, it really is on the legislature to to meet those dates. Just as they meet the dates in the Constitution for passing the budget every year. And when this program does go into action later this year, how many measurements will it affect? And will we see that number rise due to the pandemic? So the official number based on, you know, the Washington University research that was done before we even filed was north of 230,000 uninsured Missourians will gain coverage. I think it's certainly fair to, you know, guess that that may increase because of the the job losses that have happened during the pandemic. But, you know, I would take that all the more reason why it's critical to get it up and running. And bring them bringing up politics. One of the repeated criticisms of Medicare expansion, regardless of the state's past and is that it'll cost the state too much money on

fronts, right? Because this is a federal reimbursement program. Is that accurate? Yeah, so Medicaid has always been a federal state partnership. So, Missouri pays part of the cost. The federal government pays part of the cost. And they pay actually the majority of the cost. Medicaid expansion in particular is a really great financial deal for the state because the federal government will pay 90% of the cost for the increased population. And that's, you know, for as long as we've got it. And actually, we will be saving so much on programs where we currently spend money that it sounds counterintuitive. But the state will actually come out ahead financially because we will be able to cover these folks through this program where the federal government is paying most of the cost. Can you put that into dollars? Is there any way to speculate on how much that would save the state of Missouri? So, you know, there's a range and it depends on a number of factors, but the estimate from Washington University, which also was in the estimate that the state auditor put in the ballot measure, was up to a billion dollars in savings a year. You know, could

be less, could be more. You know, but I think maybe what's more helpful as people hear that and think, you know, how could that possibly be true? Right? How do you cover 230,000 more people and save money? And that is because we have a lot of these folks covered currently through programs that Missouri pays, you know, a lot more money for more than the 10 percent will pay for the new population. So, for example, we have a state program that we provide Medicaid to people who are blind and low vision. And we pay 100 percent of that cost as a state. Most of those folks will qualify under this new program based on their income. And so the state will go from paying for 100 percent of their car to paying 10 percent of their care. And there are a number of populations like that. And so that's where we see some of the savings. Jen Burstale is the executive director at Missouri Health Care for All. Thank you. Thank you for speaking with me. Thank you so much for having me.