The Washington University School of Medicine committed to donate $250,000 to Healthcare for Missouri, a campaign committee working to expand Medicaid to over 200,000 Missourians.

The commitment comes on the heels of a joint letter from Chancellor Andrew Martin and Dean of the School of Medicine David Perlmutter extolling the benefits of expanding Medicaid coverage in Missouri.

Healthcare for Missouri supports a 2020 ballot initiative to expand Medicaid coverage to any individual under 65 who makes less than 133% of the federal poverty line. Missouri is one of 14 states yet to expand coverage under those guidelines. The expansion was a key component of the Affordable Care Act, under which the federal government pledged to cover 100% of costs for states who signed up before 2017. Missouri’s delay means that only 90% of the funding will come from the federal treasury; it will be on the hook for the remaining 10%.

“I hate to say something political, but I will. It’s a travesty that the state of Missouri has not done it,” Perlmutter said. “The cost of not doing that is in the order of billions of dollars.”

Perlmutter said every department of the School of Medicine is pitching in money to the contribution, which he says is indicative of the School of Medicine’s cohesion on the issue.

“The decision was unanimous,” Associate Vice Chancellor for Medical Public Affairs Joni Westerhouse said of the decision to contribute to Healthcare for Missouri.

The donation will come solely from the Medical School. According to Perlmutter, this is because the Medical School wanted to be responsible for “taking a lead” on the issue.

During the process, Perlmutter consulted with the University’s Office of Government and Community Relations. He said they were initially hesitant to wade into the issue again, having been upset by past failed efforts in the state to expand coverage, and wanted to limit the University’s political exposure in a traditionally red state.

The School of Medicine has not commissioned a study into the possible effects of the Medicaid expansion on its bottom line, but Perlmutter says the amendment could end up as a revenue drain for the School of Medicine, since it loses money each time it treats a Medicaid patient. Perlmutter said that this doesn’t matter since it is a part of the school’s mission to be a safety net provider.

Perlmutter pointed to the benefits reaped by other states that have expanded coverage such as better health outcomes across racial and economic lines and increased funding for infrastructure and education.

“It’s such a logical thing for the state to do,” Perlmutter said. “Health correlates with education, and education correlates with health.”

According to Westerhouse, this is the first statewide initiative that the University has financially supported in at least 10 years. The University has issued statements on a range of local and statewide ballot initiatives in recent history, from its support of a 2008 sales tax increase to fund MetroLink, to its more recent rejection of a statewide cigarette tax that blacklisted stem cell research and abortion services from recieving funding.

Perlmutter said he often declines entreaties from faculty asking the School of Medicine to take a political stance, but the undeniable benefits of Medicaid expansion compelled Perlmutter to throw the School of Medicine’s support behind the initiative.

“This is something that is so positive for the community we serve and for the community that we are in,” Perlmutter said. “It has such a huge potential to improve the economy of the state.”

The University has historically prized its political neutrality, rarely making statements on political issues. Recent exceptions include then-Chancellor Mark Wrighton’s open letter to Donald Trump in support of DACA and Chancellor Martin and Dean Perlmutter’s joint letter championing Medicaid expansion.

Healthcare for Missouri has received considerable financial support from the healthcare industry in Missouri. The Kansas City Star reported that they received close to $1.1 million from healthcare advocacy group Health Forward Foundation, as well as 250,000 from healthcare network BJC Healthcare. One of BJC’s hospitals, Barnes-Jewish Hospital, is a close partner of the School of Medicine.

According to spokesman Connie Farrow, Healthcare for Missouri does not comment on individual contributions but emphasized the importance of each contribution in a statement to Student Life.

“We will raise the funds needed to put Medicaid expansion on the ballot and get the facts out so voters can decide what’s best,” Farrow wrote.
Farrow said that the campaign has already collected a quarter of the 172,000 signatures required to put the amendment on the 2020 ballot.

To Perlmutter, the School of Medicine’s support for the campaign is not just a one-off commitment, but part of a broader commitment to bettering its environs.

“Me, the medical school leadership and our new chancellor feel this is just really important for our community, and our community is important to our success as a university,” Perlmutter said. “They go hand in hand.”