In Defense of Medicaid: A Public Health and Moral Imperative

The Community Health Commission of Missouri (CHCM) is compiling powerful stories from Missouri community members, illustrating the critical role Medicaid plays in the lives of all Missourians and what is at risk if access is rolled back, restricted, or underfunded.

The following story comes from Dr. Fred Rottnek, a physician, public health advocate, and Director of Community Medicine, Program Director of the Addiction Medicine Fellowship, SSM Health/Saint Louis University School of Medicine. With more than two decades of experience caring for people in jails, prisons, and community-based treatment programs, Dr. Rottnek shares a powerful perspective on how Medicaid has transformed lives, ensuring continuity of care for individuals reentering the community and expanding access to life-saving treatment for those with substance use and mental health conditions.

Continue reading to hear Fred’s powerful testimony. If you would like to download a copy of his words to share with relevant policymakers and stakeholders, please use the button below.

In Defense of Medicaid: A Personal and Policy Imperative 

By Fred Rottnek, Director of Community Medicine, Program Director of the Addiction Medicine Fellowship, SSM Health/Saint Louis University School of Medicine

When people have access to healthcare, they get better.

For over 20 years, I have been a physician working in jails, prisons, and detention facilities in St. Louis City and County. And I always find it rewarding when an individual’s  blood pressure is controlled, or their blood sugars normalize, or they can walk up a flight of stairs without pausing to take a breath. In recent years, with the help of the Saint Louis University School of Law and Project Appleseed, individuals behind bars can sign up for Medicaid so that when they are released, they can continue these medications with a provider in the community.

I am also the Chief Medical Officer for the Assisted Recovery Centers of America, one of the largest partners of the Missouri Department of Mental Health in caring for individuals with substance use and co-occurring mental health conditions. Due to Medicaid expansion and presumptive eligibility, we have been able to enroll the majority of our patients in Medicaid. With this coverage, individuals have access to life-saving treatment and medications.

The health of all of us depends on the health of those of us with the fewest resources.

We know that if we take out children and older adults on Medicaid, the majority of those covered are already working. Medicaid and Marketplace are the only insurance options for more and more Missourians as employer-based insurance coverage continues to decrease.

All Missouri deserve opportunities to improve their health. Medicaid is one key tool in the policy toolbelt to improve the health of all Missourians. None of us can afford compromising this program—our communities’ health will diminish and costs of coverage will shift to other Missourians.

Maya Angelou famously stated: Do your best you can until you know better. Then, when you know better, do better.

Now is our time to do better. Support Medicaid. Enhance Medicaid. Do not cut Medicaid.

Fred Rottnek, MD

Director of Community Medicine

Program Director of the Addiction Medicine Fellowship

SSM Health/Saint Louis University School of Medicine