4 min read
Posted on 04.17.13
  • 4 min read
  • Posted on 04.17.13

From the home office:

Access to health care will be in jeopardy for thousands of families in the St. Louis region if the Missouri Legislature does not restructure and improve Medicaid this legislative session.

Right now, a little more than 120,000 people in the St. Louis area receive health coverage through Medicaid. If the legislation passes, an additional 51,000 people who today are uninsured will be covered.

"Changing Medicaid will improve the health of our citizens, create jobs, strengthen our economy, and with the expansion of mental health services reduce crime," Mayor Francis Slay said. "Our City is asking our legislators to do the right thing and the smart thing so that we can create a healthier, safer state."

A high percentage of people in jail and prison have a mental illness or addiction. By expanding health care coverage, the legislation would also expand the treatment of mental illness.

"The vast majority of Americans who struggle with mental illness are not violent. But, recent tragedies remind us that better treatment of mental illness will improve safety," St. Louis Metropolitan Police Chief Sam Dotson said. "Missouri Medicaid expansion will help identify mental health concerns early on and improve access to mental health services."

Mayor Slay sent Health Director Pamela Walker to Jefferson City today to rally alongside Governor Nixon for Medicaid reform. Mayor Slay, whose Inauguration is also today, has directed Ms. Walker to fully inform the City's legislative delegation and the City's Board of Aldermen about the significant impact on the St. Louis region if this critical legislation is not passed.

"Refusing to expand Medicaid would be a huge step backward," Walker said. "In the last 10 years, we have improved access to health care in our City. As a result, people are living longer, healthier lives. If the state does not pass this legislation, those improvements could be reversed."

Because of a unique public-private partnership that created a health care safety net, 20,000 more people have access to health care in the City of St. Louis. Because of that, health outcomes have improved:

- Overall mortality rates decreased 14 percent- Heart disease mortality decreased 26 percent- Incidence of the top four types of cancer decreased by an average of almost 10 percent- Deaths due to stroke decreased 36 percent- Diabetes deaths decreased 11 percent- Infant mortality decreased 7 percent- Childhood lead poisoning prevalence decreased 80 percent- Incidence of gonorrhea decreased 41 percent- 6 percent fewer children with asthma on Medicaid require acute care in hospital settings

But, the local health care safety net is in jeopardy. Mayor Slay has dedicated $5.5 million per year to match $25 million in federal payments for primary and specialty care for low-income residents. The federal money is set to expire at the end of the year. If the General Assembly does not pass Medicaid reform, and the federal payments are not renewed, 20,000 St. Louisans would actually lose access to needed health care services.

Millions of dollars are at stake. If state lawmakers do not act, Missouri will miss the opportunity to draw down $1.8 billion to expand health care coverage.

On the other hand, the new state legislation would add 5,300 new jobs to the St. Louis region and an additional $2.3 billion to our local economy through 2020.


1. Between 2001 and 2010, low-income residents made more than six million outpatient visits to regional healthcare safety net institutions. In 2010 alone, uninsured and Medicaid patients made more than 750,000 outpatient visits to healthcare safety net sites in St. Louis.

2. Safety net sites saw 175,000 more visits by uninsured and Medicaid patients in 2010 than in 2001, a 25 percent increase in volume without a large increase in funding during this time.

3. Use of emergency department services for non-emergencies decreased 12 percent (-20,000 visits) between 2001 and 2010. Notably, use of emergency department services for non-emergencies decreased 26 percent among the uninsured, in part due to the increase in access at community health centers over this time.

4. Between 2001 and 2010, St. Louis City and St. Louis County safety net institutions provided more than 3.6 million primary and 1.1 million specialty care visits. They grew by 25 percent and 30 percent, respectively, during this time.

5. Four new, state-of-the-art Federally Qualified Health Center community clinics have opened in the past 10 years in the City (Grace Hill South City, Grace Hill Water Tower, Family Care Forest Park Southeast, and Family Care Carondelet). The region also has made substantial, multi-million dollar renovations at three other sites (BJK People's on Delmar, Grace Hill's Murphy O'Fallon clinic, and Grace Hill's Soulard/Benton sites) and has invested more than $350 million in our "community clinics" through Regional Health Commission and community partner efforts since in 2001. As a result, our region has seen a 25 percent increase in outpatient visits by low-income residents to community health centers in the past decade, which likely has been a significant contributor to the improvements in many health indicators throughout our community-especially in the City-between 2001 and 2010.