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  • Rhonda Dolan

Medicaid Expansion in Missouri: The Numbers Give the Green Light

What if I told your your hard earned federal tax dollars were going to another state to pay for their healthcare coverage?


I don't believe that the government has a responsibility to take care of its citizens. However, healthcare is currently a crisis in the United States. In 2010, the Affordable Care Act was passed, ordering states to expand their Medicaid programs to include adults who make 138% above the poverty level. Despite the fact that this bill was passed with the intention to ensure that all Americans could have access to health insurance coverage, in 2012 the Supreme Court ruled that states could not be punished for choosing not to expand Medicaid. Missouri chose to reject federal funds to expand Medicaid, leaving behind an estimated 352,000 people in the state who would have been covered by the program if it expanded. Currently, in Missouri, families with children are only eligible if they make under 122% of the federal poverty level. This is only an income of a little over $30,000 to support a family of four. Under the current system, there are families left without coverage who make too much for Medicaid and too little to qualify for ACA benefits. This year, in Missouri, we have a chance to change that.

Missouri citizens worked together to send 350,000 signatures to Jefferson City to get Medicaid expansion on the ballot in November of 2020. Many worry that Medicaid expansion would cost too much money, when in fact, choosing not to expand has kept billions of federal dollars from being utilized to benefit Missourians. From 2013-2022, if Missouri chooses not to expand Medicaid, the state will have lost out on 17.8 billion dollars in federal funding. As Missourians pay taxes, we are already paying for the expansion in other states. Why should we not reap the benefits ourselves?


The loss of the possibilities of expansion can be seen in the healthcare sector in the state. Hospitals that treat uninsured patients are running out of funding. The federal funding that is gradually diminishing was intended to be replaced by funds from the Medicaid expansion, which our lawmakers refused us. From 2013-2022, without expansion, hospitals in the state will lose $6.8 billion. The state has lost six rural hospitals in the last five years and healthcare, which is the biggest employment sector in the state, has seen a slowed growth in jobs since 2012, behind states which have expanded Medicaid.

Researchers at Washington University concluded that Medicaid expansion in 2020 would be revenue neutral and would even save the state $39 million, as access to care would decrease uncompensated care and increase prevention. Looking forward, they projected that costs in the state for 2020-2024 would be higher if Missouri does not expand Medicaid.


There seems to be little reason for the legislature to not expand Medicaid this year. Not only is it granting Missourians the benefits of federal funds intended for them, but will save the state money and bolster the healthcare industry, providing and saving jobs. Beyond that, the Covid-19 pandemic has revealed how dangerous it is for Missourians to only have a realistic option of healthcare through their employer. I believe that no Missourian should have to be reluctant to take their child to the doctor or pick up a prescription for fear of cost because they are uninsured. The numbers back up the human and social need for Medicaid expansion in Missouri. We need to hold our lawmakers accountable for doing what is best for our state and us, its citizens.


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Rhonda Dolan

For Representative

MO House District 31

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Paid for by Dolan for Missouri Sonci Bleckinger, Treasurer

PO Box 755 

Blue Springs, MO 64014

Rhonda@DolanforMissouri.com