Next week, on August 4th, voters in Missouri will have a chance to weigh in on Medicaid expansion — becoming the 6th state to do so. Oklahoma voters just passed a similar expansion measure on June 30 of this year, leaving only 13 states left still refusing federal Medicaid funding to extend affordable health coverage to parents and other adults.
Medicaid expansion is often not perceived of as a kids’ issue but, as we have said repeatedly, it should be. While kids’ eligibility for Medicaid does not change when a state moves to expand coverage to more adults, kids have much at stake. In short, kids benefit when their parents do – and children in Missouri will too if the voters say yes.
In fact, given that Missouri has had one of the sharpest increases in the number of uninsured children nationwide, the ballot initiative is especially important. From 2016 to 2018, 12,000 more children became uninsured in Missouri – an increase of 17%. Missouri ranked #8 in the country with respect to the increase in their child uninsured rate.
It has been long established that when parents have health insurance, their children are more likely to as well. The ACA Medicaid expansion covers adults currently without dependent children under 138% of FPL and parents with kids in the home who have low incomes but exceed their state’s mandatory coverage levels. For example, in Missouri, parents are only covered if they make at or below 21% of the federal poverty level (or $456 a month for a family of three). This is the third lowest income level in the nation for parents – only Texas and Alabama are lower. So many parents will benefit from their coverage expansion and the outreach and awareness that arises from this expansion will result in a “welcome mat” effect for their children who may already be eligible but not currently enrolled.
In addition to coverage gains, children benefit from the economic security that comes with health coverage for the whole family and the protection it provides from medical debt and even bankruptcy. But there is more at stake for families — research shows that states expanding Medicaid improve the health and health care access of women of childbearing age, reducing adverse health outcomes before, during and after pregnancies. This includes reducing maternal mortality and infant mortality rates – one study found a 50% greater reduction in infant mortality in expansion v. non-expansion states. Gains were also seen in the reduction of pre-term births and low birthweight especially for Black infants. Medicaid expansion won’t erase harsh racial disparities for Black women and their babies, but it is an enormously important step in that direction.
If voters do decide to expand Medicaid in Missouri, a large body of research shows that children’s health and wellbeing will benefit.