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Missouri Approves Medicaid Expansion   08/05 06:18


   COLUMBIA, Mo. (AP) -- Voters on Tuesday made Missouri the 38th state to 
approve expanding Medicaid health care coverage to thousands more low-income 

   Support for the constitutional amendment means that as many as 250,000 more 
adults could choose to be covered by government health insurance beginning in 
July 2021, according to estimates from the state auditor.

   "As Medicaid expansion is fully and expeditiously implemented so that 
Missourians are no longer forced to choose between putting food on the table 
and seeing a doctor, today's victory will be a true turning point in the 
history of the Show Me State," said A.J. Bockelman, the pro-Medicaid campaign 

   The vote on health care, which was paired with Missouri's primary elections, 
came as confirmed coronavirus case s have been rising in the state and the 
economy continues to suffer.

   "I believe the economy is going to bounce back strongly but not anytime 
soon," said 62-year-old Jim Roberts, an employee in the Clay County 
Prosecutor's office in Liberty who voted to expand Medicaid. "Jesus said 'The 
poor will be with you always,' but we still need to address the concerns of 
those who are less fortunate."

   Concerns about the virus appear to have driven a record number of people to 
cast absentee ballots in Missouri's largest jurisdiction of St. Louis County, 
said county election director Eric Fey. Election officials said coronavirus 
concerns also led to a somewhat larger number of cancellations and no-shows 
among poll workers in the St. Louis and Kansas City areas, though substitutes 
were dispatched to fill the gaps.

   Voters on Tuesday also picked the Republican and Democratic candidates for 
Congress, statewide offices, and state legislative seats.

   Cori Bush, a onetime homeless woman who led protests following a white 
police officer's fatal shooting of a Black 18-year-old in Ferguson, ousted 
longtime Rep. William Lacy Clay in Missouri's 1st District Democratic primary, 
ending a political dynasty that has spanned more than a half-century.

   St. Louis Circuit Attorney Kim Gardner, whose job performance has been 
lauded by some civil rights activists and criticized by President Donald Trump 
and other leading Republicans, also won a challenge from former homicide 
prosecutor Mary Pat Carl.

   Missouri's Republican-led Legislature has repeatedly rejected Medicaid 
expansion proposals over the past decade, prompting supporters to turn to the 
initiative process.

   Idaho, Maine, Nebraska, Oklahoma and Utah have all expanded Medicaid through 
ballot questions following inaction by state lawmakers, according to the 
nonpartisan Kaiser Family Foundation. Oklahoma became the 37th state to expand 
eligibility for Medicaid under the federal law last month.

   Missouri's Medicaid program currently does not cover most adults without 
children, and its income eligibility threshold for parents is one of the lowest 
in the nation at about one-fifth of the poverty level.

   The ballot proposal will expand eligibility under the terms of the 2010 
federal health care law signed by President Barack Obama. That law provides a 
higher-than-usual federal funding share for states that expand Medicaid 
coverage to adults earning up to 138% of the federal poverty level, about 
$17,600 for an individual or $30,000 for a family of three.

   The office of Democratic Auditor Nicole Galloway, who won the Democratic 
primary for governor on Tuesday, said the financial impact on the state was not 
clear. The office has estimated that expanding Medicaid could cost the state at 
least $200 million or save as much as $1 billion annually by 2026. Republican 
opponents cited the potential costs as reason to oppose the ballot initiative.

   Bonnie Ciro, 73, a hairdresser in Liberty, said she voted against the 
proposal because she doesn't trust politicians to use the money, and she 
doesn't want to pay higher taxes.

   "It's too much money," Ciro said. "I think it's a scam, I don't trust what 
they say. (Politicians) tell you one thing and then do another thing with these 
kinds of programs."

   By proposing a constitutional amendment instead of a new law, Missouri 
supporters have ensured that lawmakers will be unable to change it without 
going back to voters.

   Republican Gov. Mike Parson, who opposes Medicaid expansion and won the 
Republican primary for a full term, moved the vote on the proposal up from the 
Nov. 3 general election to Tuesday's primary. Parson said the earlier vote 
would give the state more time to financially prepare for Medicaid expansion, 
if it passes. He said his decision was not about politics.

   Galloway's campaign has said Parson switched the day of the vote on Medicaid 
because fewer people typically vote in August compared to November, possibly 
giving opponents a better chance of defeating the measure.

   Voter turnout during the 2016 presidential general election in Missouri was 
almost three times higher than turnout for that year's August primary. Even in 
2018, a record year for turnout during a primary, roughly 1 million more voters 
turned up at the polls in November compared to August.

   Local election authorities projected a statewide voter turnout of nearly 37% 

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