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193,420. That’s the number of uninsured Missourians who would have qualified for coverage if the state’s Republican lawmakers had accepted federal funds to expand Medicaid under the Affordable Care Act (ACA). These jokers turned down the chance to recover a big enough chunk of the tax dollars that we Missourians send to Washington D.C. to pay 100% of the expansion for three years and 90% thereafter – and, no matter what they do in the future, they’ve already cost us the first year’s 100% free ride.  

Put another way, 193,420 is the number of Missourians that we know for sure will pay the price for the Republican anti-Obamacare tantrum. The actual number is probably higher given other aspects of GOP ACA obstructionism in the state – refusing to create a state exchange, attempting to sabotage the “navigators” who have been hired to help people sign up, and, of course, the constant barrage of GOP lies and distortions about Obamacare.

The source of 193,420 number is this interactive map from a TPM report. If you take a look at it, you’ll note that the only state bordering Missouri that has also failed its ACA Medicaid eligible population is Kansas, one of the few states heading to the bottom faster than Missouri. Will somebody tell Missouri’s legislators that this is not a competition we want them to win?

Of course, it’s likely they won’t care. As the article’s author, Dylan Scott, observes:

… it’s the poorest people who make up those 4.8 million [nationwide] who are missing out. Because of a kink in the law’s language, people between 100 and 133 percent of the poverty level will still be eligible to receive financial help to purchase private coverage on the insurance marketplaces that opened Oct. 1.

But those actually in poverty will be out of luck.

And of course, the very poor are the same people our Republicans seem to have been either ignoring or targeting with destructive legislation for several years now.

Nevertheless, you could let your state rep know if 193,420 unnecessarily uninsured Missourians  not only upsets you but leads you to view his or her performance less charitably. Governor Nixon has called a meeting on Nov. 26 with the two legislative committees that  have been “studying” the Medicaid expansion issue (like it needs more study). He framed the meeting as important because Missouri’s health care system “falls short ‘delivering the quality, affordable and accountable care Missourians need and deserve.'” Messages from constituents reiterating that claim, perhaps leavened with a little – polite but righteous – indignation, might help him make that case on the 26th.