Governor Jay Nixon says a study by the RAND Corporation is further evidence Missouri needs to accept Medicaid expansion under the federal healthcare reform plan.

The study looked at 14 states that were considered the least likely to accept Medicaid expansion and found that they will spend $1-billion more to pay for uninsured patient care, than if they did choose expansion. Study co-author Carter Price says Missouri was not one of those states, but the same findings apply in any state that doesn’t take the expansion.

“That state will see more people uninsured and because the federal government would have been spending money to cover those people on Medicaid, there will be fewer federal dollars flowing into that state. Furthermore, the state and local governments will have more spending on uncompensated care.”

Price says states that adopt Medicaid expansion later won’t take as great a hit, but won’t take advantage of the federal government picking up the full cost as will states that have already chosen expansion.

The study also predicts that in those 14 states, 19,000 more people could die annually than if the state does accept expansion.

“There was a study in the New England Journal of Medicine last year that took a look at states that had expanded Medicaid in the past, and what the mortality effect of that had been in those states. We used the number that they derived and applied that to the Medicaid expansion.”

Price says often overlooked is that taxpayers in states who do not adopt Medicaid expansion will still pay for expansion.

“The Affordable Care Act … every dollar that it spends, it brings in a dollar in either new taxes, fees or a reduction in spending elsewhere, and so those states that choose to not expand Medicaid … the Supreme Court allows them to opt out of Medicaid expansion. It does not allow them to opt out of the taxes, fees and spending reductions that pay for the Medicaid expansion.”

The RAND Corporation story on the study can be seen here.