With the 2013 legislative session a few months away, state lawmakers are faced with the difficult task of deciding if they will expand Medicaid to cover an 133 percent of the federal poverty line.
Wrap: 63-year-old Linda Spence is a full time student at Missouri University at Kansas City.
She used to be a program director on campus.
After she lost her job in 2007, she lost her health insurance and does not qualify for Medicaid.
Linda says there aren't many options for people in her situation.
|Description: "Those single people, who are not on their parents insurance, and are not yet 65 are just...out of luck."
Because the U.S. Supreme Court ruled it was unconstitutional to force states into expanding Medicaid, Missouri has a choice of whether or not to extend coverage to people like Linda Spence.
The federal government has offered to pay 100 percent of the costs for expansion for three years, but by 2020, Missouri would have to chip in 10 percent.
Senate Appropriations Chair Kurt Schaefer says public education funding would take a big hit if the state decided to expand.
|Description: "When you're looking at increases of potentially 100 or 200 million dollars that you have to find because of expansion, there is only one place where there is a pot of money big enough to take that. And that is public education."
Licensed physician and Senator Robert Schaaf from St. Joseph says there is no moral obligation to cover anyone under 133 percent of the poverty line as the federal government proposes.
|Description: "We already take care of kids, and we take care of the disabled, and we take care of the elderly. These people are able-bodied, and it would be wrong for us to give them free health care and put them on Medicaid, and expect other working adults to pay for them."
Missouri Health Advocacy Alliance Director Andrea Routh says the hospitals agreed to lose disproportional share funds that pay for the coverage of the uninsured. She says many hospitals risk going out of business if the share funds are not supplemented by the federal dollars for Medicaid expansion.
|Description: "Some rural hospitals probably won't make it financially, and that means not only the uninsured won't have a hospital in that part of the state, but the people who have coverage won't have a hospital in that part of the state."
Spence says expanding Medicaid for people like her would take away the uncertainty of knowing they would be able to survive Medical issues
|Description: "It could only be a win-win for those of us who are in this hole so to speak. We're just lost between a rock and a heard place. You're not single with children, and your not old enough to qualify for Medicare, so its like stay healthy or die."
In just two more years, Spence will be elligible for Medicare benifits.
The federal government will start implementing the expanded Medicaid program with participating states in 2014.
Missouri Governor Jay Nixon has not taken a stance on the matter.
Reporting from the Capitol, I'm Brendan Cullerton.