Missouri Medicaid Expansion Passes


Voters endorsed the "Yes On Two" campaign, voting to expand Medicaid in Missouri. - DOYLE MURPHY
  • Voters endorsed the "Yes On Two" campaign, voting to expand Medicaid in Missouri.

For more than a decade Republican lawmakers in Missouri have been able to stiff-arm Medicaid expansion, but voters on Tuesday passed a measure to step around them and give some of the state's poorest residents health care.

The initiative, Constitutional Amendment Two on the ballot, is expected to make more than 230,000 people eligible for health care coverage in 2021. Under the new rules, people making less than 133 percent of the poverty level will qualify for Mo HealthNet, Missouri's Medicaid Program. That works out to an annual income of less than $18,000 a year for individuals.

With all but a handful of precincts accounted for, the state's unofficial vote tally had the amendment passing by several percentage points, pushed over the top by its massive popularity in St. Louis and St. Louis County.

Republican leaders, including Gov. Mike Parson, fought extending coverage to more of Missouri's poorest residents, arguing the state couldn't afford it. That continued through the primary, even as studies, including an analysis by the Institute for Public Health at Washington University, found that providing health care for more people would actually save the state money.

Making sure more people can go to the doctor and protecting endangered rural hospitals will help Missouri in the short and long term, proponents argue.

Under the Affordable Care Act, the federal government will match 90 percent of the costs of the newly eligible. That's not as good as the 100 percent match that Missouri could have had if it had expanded at the beginning of the program, but supporters say it is still a good deal financially.

Right now, the Washington University analysis shows, Missouri loses about $500 million a year in federal income taxes because residents pay into the system that funds Medicaid expansion without getting the benefits of that expansion.

Missouri will be the 38th state to approve Medicaid expansion.

We welcome tips and feedback. Email the author at doyle.murphy@riverfronttimes.com or follow on Twitter at @DoyleMurphy.
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