In 2012, the 19-year-old Major League Baseball phenom Bryce Harper was asked an ignorant question after playing a game in Toronto. As the minimum age for drinking alcohol in Toronto was 19 (as opposed to 21 in the United States), a reporter asked Bryce if he would celebrate his home run by buying a beer. Harper instantly became an icon for his answer, sparking many tee-shirt and internet memes: “That’s a clown question, bro.” Harper had previously made it clear the he wouldn’t drink alcohol; the question did not appropriately match his personal values.

On Nov. 6, Utahns will vote on Proposition 3. Passing this ballot initiative will mean that 150,000 individuals who previously have not had appropriate medical coverage will receive it under Medicaid. Despite overwhelming evidence that expanding such coverage to these individuals who fall into this insurance gap will improve their lives, the state economy, and the lives of all of the rest of us, there continue to be many who oppose it.

So why wouldn’t we expand Medicaid?

Economic reality necessitates the need for Medicaid expansion. The unique economics of health care support the need for such public intervention. No country in the world has ever had an effective health care system without some form of governmental support. The majority of those needing coverage are working, or going to school, or caring for sick loved ones, or otherwise positively contributing to society, yet simply can’t afford insurance.

Medicaid is undeniably a program most commonly used to help people get ahead rather than worrying about what happens if they get sick. Having this health care coverage will allow Utahns to invest in themselves and their families, ultimately making our neighborhoods, communities, and state stronger. Expansion does not create incentives for people to avoid working; the median length of time spent on the Medicaid program in Utah is just over two years. Republican Gov. John Kasich in Ohio credits their Medicaid expansion with helping 290,000 Ohioans transition off Medicaid after getting a job or a raise.

A healthy economy needs healthy people. Medicaid expansion will both help Utah’s economy and improve the health of low-income Utahns. To accomplish this, Utah has to pay for 10 percent of the program, which is done through a sales tax increase on non-grocery items of 0.15 percent — equivalent to a cent on a movie ticket. That allows us to bring back our tax dollars from the federal government, existing money that is currently being used in other states that have already expanded Medicaid. Multiple independent analyses suggest a significantly positive economic impact on Utah — upwards of $1.7 billion in economic growth. Having more people covered means less work delinquency, more consistent local business services for everyone, and decreased premiums for others. It means greater financial support to medical providers, hospitals, and other entities that care for sick individuals. It means new jobs. It means better jobs for many. It means stability for those who are trying to obtain it but simply cannot.

Proposition 3 is an investment in people. It expands a program that has proven to be effective and useful to the health and well-being of millions of Americans. It enhances our economy and impacts the financial and physical health of all Utahns. It supports the prevalent American and Utah values of hard work and contributing to the whole for the benefit of all, and does so in a responsible way.

So why wouldn’t we expand Medicaid? That’s a clown question, bro.

Kyle Bradford Jones

Kyle Bradford Jones, M.D., is president-elect of the Utah Academy of Family Physicians.