Jefferson City, MO – On August 4th, Missouri voters will decide if Medicaid should be expanded to cover more Missouri individuals.
A science note compiled by MOST Policy Initiative highlights the primary scientific findings associated with Medicaid Expansion. Medicaid is a joint federal and state program established in 1965 to provide health insurance to low-income families, seniors, and individuals with disabilities. Under Medicaid expansion, adults (age 19-65) with a household income less than 138% of the federal poverty level would be eligible to receive Medicaid coverage.
To date, 37 states, and Washington, D.C. have expanded Medicaid through legislation or ballot initiatives, including Arkansas, Illinois, Iowa, and Kentucky. States that have adopted Medicaid expansion report that their populations have increased access to medical care and resources, including mental health treatment, relative to non-expansion states. These states have also reported that Medicaid expansion is associated with decreased mortality rates, including mortalities resulting from opioid overdoses.
“None of the states that expanded their Medicaid programs have reversed it,” said Brian Kinkade, vice president of Children’s Health and Medicaid Advocacy with the Missouri Hospital Association. “I think that’s pretty strong evidence that states have found expansion to be a positive experience. It’s good for their citizens and good for their state budget.”
The greatest benefit clearly will be to the estimated 231,000 adults and 40,000 children who will gain access to coverage, said Tim McBride, Ph.D., professor and health policy analyst at Washington University in St. Louis Brown School of Social Work, Public Health, and Social Policy.
“There are a myriad of benefits they will gain. The research shows the Medicaid expansion will reduce their out of pocket costs, improve access to care, and improve health outcomes and mental health status, as well as other non-health outcomes. The research has also shown that the expansion has reduced housing evictions, for example, and medical debt,” said Dr. McBride.
According to Kinkade, Missouri’s rural communities and rural hospitals would benefit greatly from an expansion. “The rural hospitals, in particular, are under a lot of financial strain right now. Having more patients covered with insurance will be good for those rural hospitals financially,” he said.
“The more patients who are uninsured or underinsured makes it difficult for the hospital who are already strained. If the uninsured can’t pay their bills, then the hospital has to shift that cost to someone else and that doesn’t happen very efficiently—to some extent, they shift costs to other payers who have insurance and makes their care more expensive,” said Kinkade.
“Folks who don’t have insurance don’t often have the resources to pay for the care they receive. More people who have insurance will tend to be healthier financially and that’s important, not just for the hospital but for the community,” he said.
Under Medicaid expansion, the federal government would cover 90% of expenditures for newly eligible enrollees, leaving the state to cover 10% of new expenditures. Due to uncertainty in several assumptions relating to the fiscal consequences of Medicaid expansion, including the number of new enrollees and cost per enrollee, there is uncertainty surrounding the net fiscal impact of Medicaid expansion.
According to non-partisan analysis by researchers at the Institute for Public Health at Washington University, Medicaid expansion would most likely result in approximately $39M of net savings to the state. However, this outcome could range from $95M of savings (best-case) to $42M of costs (worst-case). Other macroeconomic feedback effects, such as increased economic activity and employment, have been modeled and suggest net positive fiscal outcomes for states that have expanded Medicaid, but these factors vary from state to state.
Dr. McBride said there are areas of agreement between his analysis and the state’s analysis. The number of people he estimates would be covered is 230,000 adults isn’t that different from Missouri’s estimate of 286,000.
They also agree Missouri will save money in the areas of pregnant women and uncompensated care.
“We believe that after the expansion starts, some permanently and totally disabled individuals who become newly eligible would not go through the arduous process of applying for Medicaid as disabled, but would apply as expansion- eligible based simply on income,” he said.
MOST Policy Initiative is a nonprofit organization aimed to improve the health, sustainability, and economic growth of Missouri communities by providing objective, non-partisan scientific information to Missouri’s decision makers. For more information, contact Rachel Owen, MOST Director – firstname.lastname@example.org.
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Jefferson City, MO – Missouri legislators are busy wrestling with important matters for the state, and Missouri Science & Technology (MOST) Policy Initiative has come up with a way to improve the flow of unbiased scientific information to decision-makers. MOST Policy Initiative is now accepting applications for the inaugural class of MOST Policy Fellows to address this need.
Scientifically-trained fellows will inform legislators and the general public about science and technology associated with proposed policy, in order to promote long-term health, sustainability, and economic growth for Missouri communities. Fellows will be assigned to suites of committees in the Missouri General Assembly covering the following topics:
- Life Sciences, Agriculture, and Conservation
- Education and Workforce
- Healthcare and Wellness
- Technology and Engineering
- Economics and Finance
Fellows must hold a terminal degree (Ph.D. or equivalent highest-level degree for a field, such as an M.D.) in science, technology, engineering, math, medicine, or related discipline (i.e., STEMM education, nursing, etc.) upon beginning the fellowship program in September 2020. Fellows will commit to a one-year fellowship term and will be encouraged to renew their fellowship for an additional one-year term. Fellowship applications opened on February 1, 2020 and must be submitted by March 15, 2020 at 11:59 PM CDT.
The initial class of MOST Policy Fellows is supported by grants and contributions from the James S. McDonnell Foundation (St. Louis, MO), the Gordon and Betty Moore Foundation (Palo Alto, CA), the Chan Zuckerberg Initiative (Redwood City, CA), and the University of Missouri (Columbia, MO). The MOST Policy Fellows Advisory Board will serve as the Fellow Selection Committee.
The MOST Policy Fellows program will form a public-private partnership between the Missouri General Assembly, higher education institutions in our state, private foundations, the citizens of Missouri, and other interested groups seeking to advance science and technology. The benefits of this fellowship program are numerous, including, but not limited to advancing Missouri’s standing as a leading state in research and development, agricultural and environmental management, and health care; as well as stewarding an informed citizenry. For more information or to apply, please visit https://mostpolicyinitiative.org/fellows/.
MOST Policy Initiative today launches the Missouri Local Science Engagement Network, a grassroots science engagement and advocacy program aimed at elevating the role of science and the science community in civic and policy decision-making in Missouri.
The Missouri Local Science Engagement Network (LSEN) is a program of MOST Policy Initiative, in partnership with the American Association for the Advancement of Science (AAAS). Missouri LSEN will recruit and empower cohorts of local science advocates; provide training and guidance in science communication, civic engagement and effective advocacy; engage with local decision-makers on how science can inform the deliberative process; and develop evidence-based and locally-relevant content to help facilitate these engagements.
Missouri LSEN will channel the commitment of an energized community to build a lasting engagement infrastructure that quickly identifies, connects with, and “plugs in” scientific experts to conversations about challenging science issues such as climate change and its local implications. The LSEN program represents a commitment from AAAS to invest resources and build capacity to establish lasting networks of local science organizations and leaders, elevating their advocacy skills in local and state science policy discussions.
“In order to help leaders and elected officials use science when making decisions, we must not only be able to communicate our science responsibly, but we must also know when, where, and to whom we communicate,” said Rachel Owen, director of the MOST Policy Initiative. “Through the Local Science Engagement Network, we are thrilled to facilitate trusted relationships between scientists and decision-makers across the state of Missouri that will help us identify opportunities to more effectively include science in policy discussions.”
The American Association for the Advancement of Science (AAAS) is launching the LSEN as a pilot program. This engagement and advocacy program seeks to establish, nurture and guide local and state-based multidisciplinary peer networks of scientists and science advocates dedicated to elevating the role of science in public policy. The goal of LSEN is to help science advocates identify opportunities to engage civic and policy leaders in the role and use of evidence-based perspectives as communities seek locally relevant climate solutions.
“Facts alone cannot help us make informed decisions,” said Dan Barry, director of LSEN at AAAS. “Because people need science, and science needs people, the Missouri LSEN will help decision-makers connect with science and scientists who can help inform their thinking about critical social and policy issues.”
Interested participants and supporters can find more information at http://mostpolicyinitiative.org.
About MOST Policy Initiative
MOST Policy Initiative is a nonprofit organization, based at the University of Missouri, aimed at bringing scientists and policymakers together to improve livelihoods for people and communities in the Midwest. MOST Policy Initiative works side-by-side with elected officials to incorporate more scientific information into state and local policy decisions, provides resources and training for scientists interested in interacting with the policy-making process, and engages with the broader community on issues related to science and technology.
The American Association for the Advancement of Science (AAAS) is the world’s largest general scientific society and publisher of the journal Science, as well as Science Translational Medicine; Science Signaling; a digital, open-access journal, Science Advances; Science Immunology; and Science Robotics. AAAS was founded in 1848 and includes more than 250 affiliated societies and academies of science, serving 10 million individuals. Science has the largest paid circulation of any peer-reviewed general science journal in the world. The nonprofit AAAS is open to all and fulfills its mission to “advance science and serve society” through initiatives in science policy, international programs, science education, public engagement and more.
Columbia, MO – The Missouri Science and Technology Policy Fellows (MOST) program, housed within the Graduate School at the University of Missouri, is excited to announce an award of $558,000 from the James S. McDonnell Foundation (JSMF) of St. Louis, Missouri. Funds will contribute to completing the development stage of the policy fellowship program and help to launch the initial fellowship class in Jefferson City. JSMF has offered these funds as a challenge grant – two of the five initial fellows will be funded by JSMF pending funding is raised for the three additional fellows, thus, MOST is actively seeking partners to fully launch the fellowship class in the Fall of 2020.
MOST Policy Initiative seeks to establish a post-doctoral Science and Technology Policy Fellowship to assist with evidence-based policy decisions in the State of Missouri. Scientifically-trained fellows will inform legislators and the general public of potential outcomes associated with proposed policy, in order to promote long-term health, sustainability, and economic growth for Missouri communities. Forty-one members of the Missouri General Assembly have signed a letter supporting the establishment of this fellowship program. The complete list can be found at http://mostpolicyfellows.org/supporters.
With support from the James S. McDonnell Foundation and the University of Missouri Graduate School, Rachel Owen has been named the director of MOST Policy Initiative. Owen co-founded MOST alongside Hallie Thompson and Mike Hendricks in 2016 and has served as a co-director with Hendricks for the past two years while completing a doctoral degree in Natural Resources. As MOST Policy Initiative Director, Owen will play a vital role in the long-term success and sustainability of the fellows program. In addition to overseeing the day-to-day operations of the fellows and facilitating the application process and training, she will be responsible for fundraising, partnership building, and public outreach. Owen looks forward to maintaining both the long-term vision and day-to-day operations of MOST Policy Initiative, and allowing Missouri to serve as a nationwide bellwether at the intersection of science and policy-making. The MOST Policy Fellowship program will form a public-private partnership between the Missouri General Assembly, higher education institutions in our state, private foundations, the citizens of Missouri, and other interested groups seeking to advance science and technology. The benefits of this fellowship program are numerous, including, but not limited to advancing Missouri’s standing as a leading state in research and development, agricultural and environmental management, and health care; as well as stewarding an informed citizenry. For more information, please visit http://mostpolicyfellows.org.