Voters in another red state ignore GOP on Medicaid expansion

Missouri Republicans urged voters to reject Medicaid expansion through the Affordable Care Act. Missouri voters had other ideas.
Image: St. Louis
The Old Courthouse is seen in front of the Gateway Arch in St. Louis, Mo., on Nov. 1, 2018.Mandel Ngan / AFP - Getty Images file
By Steve Benen

About a month ago, voters in Oklahoma -- one of the nation's reddest red states -- ignored calls from Republican officials and approved Medicaid expansion through the Affordable Care Act. Yesterday, as the St. Louis Post-Dispatch reported, voters in another GOP stronghold did the same thing.

Ignoring pleas from Republican leaders, Missouri voters approved a plan Tuesday to expand Medicaid coverage to more than 230,000 low-income people in the state. Missouri voted to expand its Medicaid program, as 53% of voters supported the measure. Missouri now joins 37 other states that have already expanded the federally subsidized health insurance program.

For those keeping score, only 12 states have, at least for now, balked at Medicaid expansion: Alabama, Florida, Georgia, Kansas, Mississippi, North Carolina, South Carolina, South Dakota, Tennessee, Texas, Wisconsin, and Wyoming.

As is always the case when another state does the sensible thing, the practical effects of Missouri's vote will be critically important to families in need: though estimates vary, nearly a quarter of a million low-income Missourians are expected to get health care coverage as a result of yesterday's vote.

A Politico report added, "The ballot measure adds 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."

Missouri is the sixth state to adopt Medicaid expansion through "Obamacare," joining Maine, Idaho, Utah, Nebraska, and Oklahoma. Each of these successful votes occurred during Donald Trump's presidency.

The list isn't likely to grow anytime soon, though the Fairness Project, which has spearheaded these ballot measures in recent years, is reportedly gearing up for a 2022 campaign in Florida.

Postscript: It's worth taking a look at the map of how Missourians voted yesterday on Medicaid expansion. It narrowly prevailed thanks to voters in the state's major population centers and nearby suburbs.

Rural voters, including many who stand to benefit greatly from the policy, voted in line with Republicans' wishes.