Last week, this newspaper’s online Ping Poll asked if the city of St. Joseph should do more about panhandlers.
More than 80% of respondents said yes, a predictable response. Some find it jarring to see so many panhandlers with homemade signs, a sight that was once associated only with West Coast cities.
Here’s one thing to consider in this poll, which is an unscientific survey of popular opinion: We went after some low-hanging fruit and appealed to people on an emotional level. What if the poll had offered a more complex question: “Should police resources be diverted from other public safety needs in order to remove panhandlers from city street corners?”
Chances are the support wouldn’t have climbed north of 80%. On this fictional poll, a person has to think twice before clicking the “yes” button, because the cost of doing something is more clearly spelled out.
Missouri voters were never asked to consider the long-term costs of Medicaid expansion in 2020. It was seen as a no-brainer, too good to be true. The federal government pays 95% of the cost to expand Medicaid to 275,000 low-income adults. The rest just vanishes as the newly insured get more preventative care and make fewer non-emergency visits to the emergency room.
But there is a cost. Back in January, Gov. Mike Parson proposed $130 million in general revenue to cover the state’s share of Medicaid expansion, money that the Republican-controlled Legislature struck from the budget because the ballot measure did not come with a funding source, unlike other states that used taxes on cigarettes, HMOs or hospitals. The Missouri Court of Appeals found that the Missouri Legislature “retained discretionary authority” to fund or not fund Medicaid expansion.
It didn’t fund it. Some of this could be attributed to a reflexive opposition to anything associated with the Affordable Care Act. There also was a failure to consider future benefits, like an improved financial position for rural hospitals.
But some of his opposition also stems from an awareness that Missouri’s Medicaid spending grew from 17% of the state budget to 24% in 2018. It will gobble of a quarter of the state budget in a couple of years, even without expansion.
This is money that’s not available for other priorities, namely education but also infrastructure, mental health and corrections. With no long-term commitment of continued federal support at the 95% level, Missouri’s elected representatives had an obligation to consider the budget ramifications.
This should remain at the top of their minds. Medicaid expansion will wind up in court, creating a scenario similar to Kansas, where judges forced the legislature’s hand on funding for education.