Missouri voters said yes to expanding Medicaid on Tuesday despite the best efforts of Republicans to block health coverage for more than 200,000 people. Missouri has had an extremely low Medicaid eligibility threshold, with most non-disabled adults excluded from coverage. Even parents are only covered in cases of the most extreme poverty—less than $5,800 in income for a family of four.
Advocates for Medicaid expansion, many of whom had been working on the issue for years, celebrated. “Amendment 2 won today,” according to Caitlyn Adams, executive director for Missouri Jobs with Justice Voter Action, “because no matter what we look like, where we live, or how much money we make, most of us want the same things—the ability to keep our families safe and well. Expanding Medicaid is a big step toward this goal.”
Missouri’s Republican secretary of state and governor had done their best to sink the effort by getting the measure on the primary ballot rather than waiting for the general election. Primaries are usually lower-turnout elections that favor Republicans. But it didn’t work, with cities voting strongly for expansion, rural areas voting strongly against, and suburbs tipping the result to yes.
This makes 38 states that have expanded Medicaid, including six red states where voters chose expansion through ballot measures. Organizers learned lessons from previous states: “The ballot measure adds the Medicaid expansion into the state’s constitution, effectively barring Republican lawmakers from adding conservative elements to the program—like work requirements and premiums—as other states sought to do following similar initiatives,” Politico reports.
Yet there are 12 remaining states that haven’t taken the Affordable Care Act’s Medicaid expansion, leaving many residents in the gap between qualifying for Medicaid and getting subsidies for private insurance, and those states aren’t moving to do the right thing for their struggling families. Expanding Medicaid also reduces racial disparities in health care. For instance, “Medicaid expansion has also been associated with a reduction in disparities in key health outcomes such as infant mortality (14.5% decline for African Americans in expansion states versus 6.6% decline for African Americans in non-expansion states) and perforated appendix (significant reductions in perforated appendix admission rates for Hispanics, non-Hispanic Blacks, and low-income communities).”
Missouri’s government is now required to notify the federal government of its intent to expand Medicaid by March 1 and do so by July.
