MO Voters Pass Medicaid Expansion; Will Other States Follow?

Missouri voters on Aug. 4 approved a constitutional amendment to expand Medicaid coverage, reflecting a trend of ballot-driven expansion initiatives in recent years that has been accelerated by the COVID-19 pandemic. Missouri is the second conservative state to approve expansion during the pandemic; Oklahoma voters on June 30 narrowly approved a ballot measure to expand Medicaid in that state.

The ballot measure requires Missouri to expand Medicaid to adults between the ages of 19 and 65 with incomes up to 138% of the federal poverty level (FPL) by next July, leaving 12 states — mostly led by Republicans — that have not adopted expansion under the Affordable Care Act (see infographic, p. 6).

© 2025 MMIT
Lauren Flynn Kelly

Lauren Flynn Kelly Managing Editor, Radar on Medicare Advantage

Lauren has been covering health business issues since the early 2000s and specializes in in-depth reporting on Medicare Advantage, managed Medicaid and Medicare Part D. She also possesses a deep understanding of the complex world of pharmacy benefit management, having written AIS Health’s Radar on Drug Benefits from 2004 to 2005 and again from 2011 to 2016. In addition to her role as managing editor of Radar on Medicare Advantage, she oversees AIS Health’s publications and manages the health editorial staff. She graduated from Vassar College with a B.A. in English.

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