Missouri voters approve Amendment 2, expand Medicaid access

Missouri voters on Tuesday elected to expand Medicaid access in the state, extending health insurance coverage to an estimated 230,000 additional people.

Missouri becomes the 38th state to approve expansion of Medicaid, the government health insurance program for low-income people and individuals with disabilities.

Amendment 2 will make individuals earning up to 138% of the federal poverty level, or about $18,000 per year, eligible for Medicaid benefits. Currently, the state caps eligibility at an income level of just below $5,550 for a family of four.

With more than 99% of precincts reporting as of early Wednesday, 53.3% of voters had approved the measure, and 46.7% had voted against it, according to unofficial results from the Secretary of State.


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Expansion is projected to provide health insurance benefits to over 230,000 people who were previously in the Medicaid gap, meaning they earned too much to qualify for benefits, but too little to afford private insurance.

Expanding Medicaid could save the state around $39 million per year, according to a study by researchers at Washington University in St. Louis. The federal government has pledged to pay 90% of the cost of expansion, with states contributing the remaining 10%.

Medicaid expansion was a key piece of the Affordable Care Act, President Barack Obama’s landmark 2010 health care legislation. Some states adopted expansion in 2014, the first year possible, and others have done so since.

Republican lawmakers in Missouri have resisted expansion for years. However, an initiative petition this year garnered enough signatures to put the issue on a statewide ballot, leading to Tuesday’s vote.

The measure had the backing of business groups across the state, including the Missouri Chamber of Commerce and Industry, as well as local chambers in St. Louis, Kansas City, Springfield and Columbia. The Missouri Hospital Association and hospitals across the state supported the measure. Two of the state’s largest private health care companies, Centene and Cerner, backed Amendment 2 with campaign contributions. Washington University contributed to the political action committee Missourians for Healthcare, according to campaign finance filings.

In a statement released Tuesday night, the dean of Washington University’s medical school hailed the amendment as a boon to individual citizens and the broader economy.

“This is a tremendous victory for a quarter-million hardworking Missourians who no longer have to live in fear of getting sick or hurt because they will now have healthcare coverage when they need it,” Dr. David H. Perlmutter said in a statement. “In addition to improving access to life-saving care for our most vulnerable citizens, Medicaid expansion will inject billions of dollars into our economy, create thousands of new jobs and benefit communities across our state at a time when it is needed most.”

Herb Kuhn, president and CEO of the Missouri Hospital Association, said in a statement that Tuesday’s vote represents a call to action for Missouri.

“Other states have provided a laboratory for how Medicaid expansion can act as a tool to transform not only the lives of the individuals covered, but the program itself,” Kuhn said. “They have used this program to both strengthen their state’s economy and improve the health status of their state. We can do the same.”


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