Medicaid expansion a must for rural Mo.

To the Editor,

Working with Missouri Highlands Health Care, I see firsthand the need for rural Missourians to have access to health care through Medicaid Expansion. This legislative session our elected officials have the opportunity to accept federal funds and extend access to approximately 300,000 Missourians. Rural Missourians make up 37 percent of Missouri's population. If Missouri expands Medicaid, 50 percent of the newly insured are located in rural Missouri. Rural Missourians face a lack of affordable and accessible healthcare. Rural Missourians tend to be older, poorer and lack access to employee based healthcare. Rural Missourians need and deserve Medicaid Expansion.

At Missouri Highlands we work for our community members every day and see what it means for individuals and families who lack health insurance.

Shannon County: Bill is a single male age 60, he is unemployed and has COPD, arthritis and hypertension. He is caregiver for his mother who is age 86 with serious health concerns, previously was on hospice care but that has been discontinued. She draws Social Security benefits and has medical coverage, but does not file tax return. Bill is not paid for his work as caregiver. He has not had health insurance for the past 10 years and needs so see a specialist. Bill has no option for affordable health coverage in Missouri.

Iron County: Delbert is single young man who was working two jobs until he had an ATV accident. He has sustained an injury that will not heal without surgery. He did not have health insurance before the accident, and he does not know how he will pay his medical bills. He cannot schedule surgery without payment arrangements. If he does not receive treatment for his injury, it will result in a permanent disability. His income is too low to be eligible for Advance Premium Tax Credits for the current year, therefore the Insurance Marketplace is not an option. His injury, while disabling, is not a total disability so he is not eligible for MO Health Net for Disabled Adults. Delbert has no option for affordable health coverage in Missouri.

Carter County: Lynn has no insurance coverage and applied for coverage through the Healthcare Marketplace. She is having some serious health issues and needs several tests and further medical treatment. She is currently working full time most weeks, making minimum wage. However her income falls just short of the minimum level for a household of 3 (she is raising her 2 daughters alone), to receive Advance Premium Tax Credits to help pay for insurance premiums through the Marketplace. She does not qualify for Medicaid either, as she is not only over income, but doesn't qualify in any of the other categories (disabled, pregnant, under 18). She is unable to further her medical treatments beyond what our clinics provide. Lynn has no option for affordable health coverage in Missouri.

Thirty-seven percent of Missouri's population is rural, which is approximately 2.2 million people. In rural Missouri, residents tend to be older and have higher rates of chronic diseases. Poor health translates into higher health care costs. That's why it's important to have services that are close to home.

Rural residents are less likely to have employer-provided health insurance or prescription drug coverage. They also have high rates of poverty. This makes the need for health insurance coverage through Medicaid Expansion crucial to rural Missourians.

Samantha Hill, RN

Missouri Highlands Health Care

Ellington, Mo.