Missouri voters passed Medicaid expansion. What happens next?


At the beginning of August, Missouri voters sent a clear message: it’s time to provide Missourians the health care we all need and for Missouri’s tax dollars come back home to benefit the state and its residents. 

The passage of Medicaid expansion on August 4 was a huge success for the uninsured and underserved, and for the economy, of our state.  

Health Forward has worked hard, and for many years, to reduce barriers to health. We are proud to have led this effort to put Medicaid expansion in front of Missouri voters. We are even prouder of the positive response of 53 percent of all voters in both rural and urban areas of the state, and that the campaign earned the support of a variety of different organizations and stakeholders Missouri-wide.  

Now, we roll up our sleeves and get to work to implement the will of the majority of Missouri voters.  

But what will this entail?

Implementation Goals

We intend to partner with MO HealthNet (Missouri’s Medicaid plan) to support the timely and efficient rollout of Medicaid expansion and enrollment of Missourians.  

The initiative petition language, which is now part of the state constitution, provides two key dates:

  • March 2021 – State plans for implementation must be submitted by Missouri to the federal government; and
  • July 2021 – Individuals 19 or older and under 65, with incomes at or below 138 percent of the federal poverty line will be eligible for Medicaid.

These dates give us crucial benchmarks for expansion. 

Leading up to March 2021, it will take creativity, cooperation, and compromise to come up with a sound plan for rolling out Medicaid to newly eligible Missourians.

By July 2021, the amendment language is clear that Medicaid must be available to qualified individuals aged 19–64 at or below 138 percent of the FPL. 

With more than 700,000 Missourians filing for unemployment and 100,000 losing health coverage due to the pandemic and resulting economic crisis, expansion will be critical to help Missourians take care of themselves and stay healthy through these particularly tough times. 

That one billion dollars we annually send to the federal government will now return to our state, improving the health of individual Missourians, and the economic health of our state budget. 

We will keep the health of our residents and our state economy in mind as we work toward implementation. 

The rollout of expansion must be robust, uncomplicated, innovative, and allow for implementation without delay or unnecessary costs. It must be a collaborative effort, taking into account best practices learned from other states that have already expanded Medicaid. It must be a process in which stakeholders and community leaders continue to be engaged to ensure those for whom we voted Yes on 2 enroll and go on to live longer, healthier lives.  

The path we take toward expansion must be right for Missouri. And we will do all in our power to ensure that it is so.