Ethical Issues: Access in Missouri

Abstract

Medicaid spending in Missouri has been growing at double-digit rates since 1998, expanding to cover almost one in five citizens and contributing to the state's growing budgetary problems. Medicaid expenditures increased by almost 50 percent between 2001 and 2005 (from $4.2 billion to $6.3 billion), predominantly due to increases in enrollment, as well as changes in case mix. In an attempt to curb this growing financial burden 90,000 enrollees were cut from the Medicaid roles in 2005 resulting in a fierce debate as to the morality of eliminating health care access for many of the most vulnerable citizens, such as the elderly, dying, and disabled.