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If Missouri’s Amendment 2 passes Tuesday, Aug. 4, Missouri will be the 38th state to expand its Medicaid program, providing additional health care coverage for more low incomes families and individuals in the state. If passed, it is estimated expansion of MO HealthNet, the state’s Medicaid program, would add about 230,000 people to its rolls. MO HealthNet already serves about 900,000.

Currently, families with dependent children are eligible for Medicaid health care coverage in Missouri if they earn up to 22% of the federal poverty level, around $4,700 per year for a three-person household. Adults without children aren’t eligible. Under the expansion, if passed, that eligibility would rise to 138% of the poverty level, about $35,500 annually per family. Expansion would also allow childless individuals to enroll if they earn less than about $18,000 per year.

Proponents contend expansion will aid rural hospitals that would see upticks in patients and provide needed medical coverage to those who needed it most.

“I have met many Clay County residents who fall into the Medicaid coverage gap. These constituents, our neighbors, make less than $17,609 per year, but do not currently qualify for Medicaid. That means they sacrifice necessities or cannot pay their bills in order to afford health care or they go without health insurance. Recently, Oklahoma voted to help more of their citizens access affordable, quality health care through a better Medicaid program. Now that Oklahoma has expanded Medicaid, Missouri is surrounded by six states that have made Medicaid available to working families,” said Missouri Sen. Lauren Arthur, who represents District 17, which includes part of Liberty and Gladstone.

“One in four U.S. adults — 61 million Americans — have a disability that impacts major life activities. ... Unfortunately, the same systemic shortfall that forces those in the health insurance coverage gap to choose between doctor visits and feeding their families also impacts people with disabilities,” said Kendra A. Burgess, public policy coordinator at The Whole Person, a social services organization in Kansas City that serves clients who have disabilities in Clay County. “This essentially locks them into poverty to maintain eligibility for Medicaid coverage or wading through the lengthy process of awaiting a disability determination before getting medical coverage through Social Security Supplemental Income.”

Opponents to expansion say program costs may increase to an unknown amount in years to come and the state’s coffers are already overburdened.

According to information from the Missouri Department of Social Services, expanding Medicaid could cost the state $200 million annually. If Amendment 2 is approved, a federal match would mean the state would only be required to pay 10% of the costs with the federal government paying for 90%.

Republican primary candidate Josh Hurlbert, who is running for Missouri House District 12, which includes Smithville, said the constitutional amendment would exacerbate the state’s $700 million COVID-related revenue shortfall “with an additional $200 million in unfunded mandates.”

“Medicaid already consumes as much or more dollars, depending on the year, than the state has available to spend on education. The spending requirements to support the existing Medicaid program already competes with the available funds for education in the state. This is especially concerning when you consider that Missouri is already cutting a projected $700 million due to COVID-19 impacts,” said United for Missouri’s Chief Executive Officer Carl Bearden. United for Missouri is a grassroots organization dedicated to fiscal conservatism and limited government issues. “Medicaid, including the expansion proposal, is one of those programs that once you start it, there’s very little you can do to get out of it. It’s a bottomless pit consuming more and more and more taxpayer dollars.”

Southeast Editor Kellie Houx can be reached at or 389-6630.

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