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Missouri Overwhelmingly Votes For Medicaid Expansion

August 05, 2020

Missouri voters Tuesday voted 53% to 47% to expand Medicaid, becoming the sixth state to do so through a ballot initiative and coming a little over a month after Oklahomans narrowly agreed to an expansion.

Like in Oklahoma, the yes vote creates a constitutional amendment that expands coverage to all residents age 19 or over earning up to 138% of the federal poverty level. The amendment also bars the state from adding requirements for the expansion population that are more restrictive than the current Medicaid eligibility standards and also mandates the state seek the maximum amount of federal funding for the expansion, which is now slated to go into effect in 2021.

According to the Fairness Project, which helped organize the ballot initiatives, the expansion will cover about 230,000 Missourians.

The American Heart Association has also been a strong supporter of the expansion effort and, following the vote, Denise Hooks-Anderson, AHA’s St. Louis Board president, praised voters for taking a big step toward improving health care across the state.

“I see at least one patient every day who is forced to make tough choices regarding their health due to a lack of insurance coverage,” she said. “Expanding access to health care provides a lifeline for Missouri families who are slipping through the cracks in our system and it halts the agonizing choice that too many families face when deciding if they can afford critical medical care – including heart disease treatments and medications.”

The expansion will also bring over a billion dollars in tax dollars that can benefit local economies and help keep rural hospitals open, she added.

“Currently, Missouri has one of the most restrictive Medicaid programs in the country, leaving out hundreds of thousands of low-income adults,”Joe Weissfeld, Families USA’s director of Medicaid initiatives, said. “Missourians went to the ballot box and demanded change. This victory, alongside the recent vote in Oklahoma, shows the popular support and importance of the Medicaid program in our country’s heartland.”

Oklahoma narrowly voted to approve its constitutional amendment on Medicaid expansion June 30, and the program is slated to go into effect by July 1, 2021, although stakeholders have called for the state to move implementation up to January.

Voters in Utah, Idaho and Maine have also approved expansions that have gone into effect, although Idaho and Utah are seeking waivers that would require enrollees meet certain work or premium contribution requirements. Nebraska approved the expansion nearly two years ago and just started enrolling people as of Aug.1 for coverage that will be effective in October. The state has also requested a waiver that would create a “basic” and “prime” version of Medicaid and people would need to satisfy a work requirement and other criteria to get the full coverage.

Jerry Vitti, founder and CEO of Healthcare Financial Inc., says Republican lawmakers should take note of the results, and also consider increasing Medicaid matching funds, which is supported by a bipartisan group of governors.

"Missouri's Medicaid expansion, along with Oklahoma and the other red states, is the bellwether of a big momentum shift," Vitti says "Health care -- Medicaid in particular -- is becoming more of a bipartisan issue. With Democrats already there, Washington should read the signal from the GOP electorate who, when asked, want Obamacare. Now the most pressing issue to red state governors who are compelled to expand is the cost. In these difficult budgetary times due to the covid-related recession, it's a very real concern. The idea of increasing the federal share of Medicaid via the FMAP will gain traction as governors, red and blue alike, look for a solution." -- Amy Lotven (alotven@iwpnews.com)