Voters will decide in August whether they want to expand health care for low-income Missourians, Gov. Mike Parson announced Monday.

The move from the November general election to the August primaries, which historically have lower voter turnout rates, means Medicaid expansion will not be on the same ballot as the elections for statewide legislative and gubernatorial seats.

If approved by voters, the constitutional amendment will expand Medicaid eligibility to an estimated 230,000 adults in Missouri, including adults earning less than $18,000 individually or $30,000 for a family of three.

Parson said the decision was made, so the state can sooner understand its financial situation moving forward with accommodations for COVID-19.

“I want to be clear. This was about policy, not politics,” Parson said. “At a time when our state is undergoing a major health, economic and budget crisis, we need to know exactly where we stand when it comes to a massive spending initiative for Missouri.”

Parson said, if the Medicaid expansion is passed, it will depend on general revenue and compete for funding with education and public safety.

The Medicaid program is currently funded by both federal and state government resources. If expanded, 90% of those covered would be paid with federal funds. In a study this year of states that previously expanded Medicaid by the Missouri Budget Project, a similar expansion would provide $100 million in annual general revenue savings in Missouri by 2024.

Missouri Auditor Nicole Galloway, a Democrat running for governor in the November election, has supported Medicaid expansion and also said the state would see an increase in savings. She will likely be running against Parson, the incumbent Republican.

“Every reputable study and the experience of other states that have expanded Medicaid show clear benefits to Missouri’s bottom line,” Galloway said in a statement.

Rep. Crystal Quade, D-Springfield, also was among Democrats who characterized the decision to move the vote as political.

“Medicaid expansion has always enjoyed widespread support among Missourians, and right now, it is more important than ever,” Quade said in a Tuesday statement. “The only thing the governor’s crassly partisan move change is Medicaid expansion will be enshrined in the Missouri Constitution three months earlier than expected.”

Currently, Missouri is one of 14 states that has not expanded its Medicaid program under the 2010 Affordable Care Act. Missouri’s Republican-led legislature has rejected Medicaid expansion initiatives in the past, causing supporters to turn to collecting petition signatures.

Secretary of State Jay Ashcroft announced Friday in a statement that enough petition signatures to place the initiative on the ballot had been verified. Nearly twice as many signatures needed were delivered to the state capitol building for verification in early May.

A.J. Bockelman, campaign manager for Healthcare for Missouri, praised the signatures’ verification in a statement Friday.

“We know access to health care is more important now than ever,” Bockelman said in the statement. “Today’s certification is a testament to those from every corner of our state who came together to overwhelmingly place Medicaid expansion on the ballot so that 230,000 hardworking Missourians no longer have to choose between putting food on the table and being able to see a doctor”

  • News reporter and assistant city editor, summer 2020. I am a second year graduate student studying public policy journalism. You can reach me at or on Twitter @MikaylaEasley

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