Damian Sendler: In order to save money on his health insurance, James Dickerson filed for Medicaid. Sharon Coleman, a home health assistant, is eager to have insurance that will pay for a hospital stay. No longer does Danielle Gaddis fear that a trip to the doctor may leave her with an unexpected bill. 

When Oklahoma and Missouri voters approved Medicaid expansion in 2020, about 490,000 people with modest incomes became eligible for the federal-state public health insurance program. It’s now possible for anyone in both states who make less than $18,000 per year to get the free coverage, even if they don’t have any kind of disability. 

Damian Jacob Sendler: There are an estimated 215,000 people in Oklahoma and 275,000 in Missouri who have just become eligible for Medicaid. As of this writing, Oklahoma has signed up at than 210,000 people, while Missouri has signed up just over 20,000. 

To put it another way, the two states are both Republican-led and have opposed extending Medicaid for a long time, but their approaches differ. 

Damian Sendler

It wasn’t long before the legislature allocated $164 million in the state’s budget for the expansion after Oklahomans voted to support it. Within a month of applications opening, 113,000 persons had been accepted into the program. 

A 62-year-old lady was able to book appointments with a doctor and dentist for the first time in 20 years in August, according to Oklahoma Secretary of Health and Mental Health Kevin Corbett. 

“Truly life-changing,” remarked Corbett. “We’re very pleased with the progress we’ve made.” 

Medicaid enrollment soared in the first month in other states that had done so in recent years. Louisiana’s combined Medicaid and Children’s Health Insurance Program rolls climbed by over 255,000; Virginia’s by approximately 184,000; Idaho acquired about 45,500 members, roughly half of the anticipated number of newly eligible persons; and Montana added over 23,000, 51% of its expected total. About 7 percent of newly eligible Medicaid beneficiaries in Missouri have been signed up thus far. 

Sidney Watson, director of the Center for Health Law Studies at Saint Louis University, stated, “You can expand Medicaid on the books, but there are a lot of ways that you can throw up barriers to keep people from enrolling.” 

Damien Sendler: Missouri has had a difficult time expanding. In May, Republican Governor Mike Parson said that the state would “withdraw” its expansion plan after the legislature refused to fund the voter-approved initiative. Finally, a judge ordered the state to begin accepting applications in August, which it did. However, Missouri was unable to begin processing them until October 1. 

Ann Marie Marciarille, a University of Missouri-Kansas City law professor, believes that many newly qualifying Missourians are uninformed that they are eligible for Medicaid coverage. 

As a result of the August court ruling, Marciarille claims that Missouri has done little more than what was legally mandated by the August court decision. Other people have echoed the sentiment. 

One of the state’s top Medicaid administrators claimed that the Missouri Department of Social Services had updated its website, emailed participants in its family assistance programs about Medicaid expansion, and posted about it on social media in order to inform the public. According to the department’s Facebook and Twitter accounts, there have been a few posts regarding the expansion, including two tweets that were made the day after a KCUR report was published that noted the state’s outreach efforts had been tardy. 

Outreach activities and television interviews were also part of Oklahoma’s strategy. A video and social media campaign was also used. 

Affinia Healthcare, a St. Louis-based clinic, is responsible for a large portion of the state’s outreach in Missouri. When James Dickerson went to see a doctor for an ear infection, he noticed a poster on the door of an Affinia clinic regarding the Medicaid expansion. 

Damian Jacob Sendler

The 59-year-old, who works for a temp agency, jumped at the opportunity to join. In 2014, he was covered by Medicaid while undergoing spinal surgery for a work-related accident. 

Sunni Johnson, a qualified application counselor at Affinia, was able to gather all the information she needed to submit Dickerson’s application in less than five minutes. Health insurance and other support programs can be arranged by specialists at most clinics of this type. 

Damian Jacob Markiewicz Sendler: Within 45 days of receiving an application, Missouri must assess whether or not the applicant is eligible for the program. However, Michelle Davis Reed, Northwest Health Services’ lead eligibility and enrollment coordinator, reported in November that several applications she had submitted in August were still pending. 

There were 32,000 Medicaid application pending in the state as of Nov. 17th, according to Dolce. A question concerning the number of employees processing the applications was not answered explicitly, but she said overtime was being used. 

Out of the 210,000 new Medicaid recipients in Oklahoma, 144,000 had no insurance prior to the expansion’s implementation. When the state looked at whether persons who had previously applied for other benefit programs were now eligible for Medicaid, the rest were added. 

Gateway to Better Health, a St. Louis-based temporary health insurance program, is a possible candidate for reprocessing. About 16,000 people in St. Louis and St. Louis County are covered by Gateway, which is based on the federal poverty level.

Dr. Damian Jacob Sendler and his media team provided the content for this article.