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Medicaid Expansion

It’s official: Missouri is the 38th state to pass Medicaid expansion!

On August 4, Amendment 2 won 53 percent of the popular vote. Its passage ensures a quarter-million hardworking Missourians will no longer have to live in fear of getting sick or hurt because they will now have healthcare coverage when they need it.

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. Now, Missouri can begin the work of implementing Amendment 2 so that low-income Missourians can have the high-quality medical care they need to pursue healthy and productive lives.


About the initiative

The Affordable Care Act offers states federal tax dollars to expand Medicaid eligibility to low-income adults caught in a coverage gap. Missouri is one of 13 states that has not expanded Medicaid. However, a 2020 ballot measure could allow voters to change that.

School of Medicine faculty and students share why they support Amendment 2 to expand Medicaid in Missouri.

Ebony Carter, MD, says expanding Medicaid can provide patients access to the medical care they need before becoming pregnant.

Katie Plax, MD, shares how expanding Medicaid can help patients keep their insurance past age 19 and improve opportunities to go to college.

Vote YES on Amendment 2

On August 4, Missourians will have the opportunity to have their voices heard on Amendment 2 to expand Medicaid, ensuring hardworking citizens have access to health care while bringing billions of our tax dollars home from Washington each year to strengthen our communities and grow our economy.

Washington University is deeply committed to supporting Amendment 2 because it is a common-sense approach to delivering health care to vulnerable Missourians that could radically shift the economic momentum of our state.


Medicaid expansion will …

Deliver health care to 230,000 hardworking Missourians

Increase economic output by $2.5 billion

Create 16,000 new jobs with an average hourly wage of at least $15

Bring $1 billion of Missourians’ tax dollars back to our state

Protect rural hospitals — 26 are now in danger of closing

Address racial inequities in health care


Amendment 2 will deliver care to citizens who try to make ends meet but have jobs that pay less than $18,000 and don’t come with health insurance. We’re talking about Missourians who make too much to qualify for Medicaid right now and too little to afford private insurance. They are caught in the coverage gap and often must decide between buying groceries or paying for vital medication and health care.

David H. Perlmutter, MD, Dean of the School of Medicine, joins medical student Hannah Truong in front of the Medicaid Ambulance Response Vehicle (MARV). MARV has been touring Missouri to bring attention to a Medicaid expansion measure on the Aug. 4 primary election ballot.

Amendment 2 will save our state money and benefit our economy. Researchers from Washington University’s Center for Health Economics and Policy have shown Medicaid expansion will save Missouri more than $1 billion annually by bringing our tax dollars home from Washington and reducing many of the health care costs the state pays now. This will create new economic growth and free up general revenue funds for other priorities, such as K-12 education, transportation and law enforcement.

To date, 37 others states – including our conservative neighbors in Arkansas, Nebraska and Oklahoma – have adopted Medicaid expansion. It’s time to make Missouri number 38!

Help us win on August 4 by voting YES on Amendment 2.

Make a plan to vote on August 4

Missourians have several ways to vote in the August 4 statewide election. Make a plan now for how, where and when you will cast your ballot.

How to vote this August

Key facts about Medicaid expansion

Answers to questions about how passing Amendment 2 will benefit Missourian’s health and our state’s bottom line:

Who will be eligible?

Medicaid expansion will deliver health insurance to 230,000 hardworking Missourians, helping them to get and stay healthy while taking care of their families. Under Amendment 2, an individual who earns up to $18,000 a year or a family of four that earns up to $36,000, would be eligible. These individuals are currently trapped in the coverage gap, meaning they go to work but their jobs don’t come with health insurance, and they can’t afford to buy it on their own.

It affects thousands of uninsured veterans, working women who don’t have access to mammograms and cervical cancer screenings, more than 50,000 parents and 18,000 near-retirees.

How will it affect Missouri’s budget?

Independent studies, including one by Washington University’s Center for Health Economics and Policy, have concluded that annual savings in the state budget resulting from Medicaid expansion are expected to reach $1.013 billion by 2026. By law, the federal government will cover 90 percent of the costs to expand Medicaid.

Medicaid expansion would also save the state money by covering many people with disabilities, pregnant women and those fighting breast and cervical cancer at a lower cost to the state than we pay now.

What other ways will Missouri benefit?

Amendment 2 has the potential to increase state revenue outside of health care. A recent report conducted by Regional Economic Models Inc. (REMI), commissioned by Missouri Foundation for Health, estimated that expansion would result in a $2.5 billion increase in economic output in Missouri. The REMI study also concluded that expansion would result in 16,330 new jobs in Missouri, with 79 percent of those jobs outside the health care industry such as retail and construction. Nine out of 10 of those jobs would pay $15 or more per hour.

How will it benefit communities of color?

Passing Amendment 2 is an important first step in righting the unconscionable disparities that disproportionately harm communities of color. There is a reason the Ferguson Commission’s 2015 report included Medicaid expansion as one of its Signature Calls to Action to address the racial and social justice inequities that continue to affect the St. Louis region. Now, more than ever, this is critical. African American Missourians have been disproportionately impacted by the Coronavirus and studies have shown that this is largely due to a lack of access to health care.

Amendment 2 will ensure 36,000 more African American Missourians will have access to much needed health care.

How will rural Missouri benefit?

Ten rural hospitals have shuttered their doors and closed for good in Missouri since 2010, forcing people to drive longer distances to reach a hospital when suffering from a heart attack or other medical emergencies. An additional 26 Missouri hospitals are considered “vulnerable to closure.” Amendment 2 will help these endangered hospitals remain open.

Webinar: What’s At Stake In The August Missouri Primary Election

A July 20 webinar featuring speakers from Washington University and the St. Louis County Board of Elections explored what is at stake and how to ensure every vote is counted in Missouri’s August 4 election. Panelists discussed the implications of Medicaid expansion for Missouri and what we all need to know about recent changes to voting laws and procedures affecting the primary.

Speakers: David H. Perlmutter, MD, Executive Vice Chancellor for Medical Affairs and the Dean of the School of Medicine; Eric Fey, Democratic Director of Elections at the St. Louis County Board of Elections; and Darrell Hudson, Associate Professor and Co-Director of the Collaboration on Race, Inequality, and Social Mobility in America at the Brown School’s Center for Social Development.

Co-hosts: Center for Social Development’s Voter Access and Engagement Initiative and the Gephardt Institute for Civic and Community Engagement with support from the Missouri Foundation for Health.

Messages from leadership

Op-Ed in St. Louis Post-Dispatch: An opportunity Missouri can’t afford to pass up (7/22/20)
By Dean David H. Perlmutter & Institute for Public Health director William G. Powderly, MD

Expanding Medicaid will have a positive impact on Missouri (7/6/20)
By Chancellor Andrew D. Martin & Dean David H. Perlmutter

Support for Medicaid expansion in Missouri (6/23/20)
By Chancellor Andrew D. Martin & Dean David H. Perlmutter

The case for Medicaid expansion in Missouri (11/4/19)
By Chancellor Andrew D. Martin & Dean David H. Perlmutter

More on Amendment 2

Yes On 2 is the grassroots, nonpartisan coalition formed to support Missouri’s Medicaid expansion initiative

Full text of the Amendment 2 ballot measure is available on the Missouri Secretary of State website

Researchers at Washington University’s Center for Health Economics and Policy published an analysis of the fiscal impact of Medicaid expansion (pdf)

Makes Sense MO provides Medicaid expansion information from the Missouri Foundation for Health