Does narrow victory in Oklahoma set stage for Missouri Medicaid expansion vote?
A win is a win, but supporters of Missouri Medicaid expansion caution against reading too much into Tuesday’s election results in Oklahoma, where voters agreed to extend eligibility for the low-income health care program by a slender 1% margin.
Oklahoma became the 37th state to endorse Medicaid expansion and the fifth to do so through a referendum vote, circumventing the will of state Republican leaders and the Trump administration, which is asking the U.S. Supreme Court to invalidate the law that made expansion possible, the Affordable Care Act.
When Missouri voters go to the polls on Aug. 4, they will be confronted with a proposed constitutional amendment to expand Medicaid for an estimated 300,000 low-income residents.
“It’s obviously very encouraging to see that Oklahoma accomplished the same type of thing as we’re trying to accomplish,” said Dave Dillon, spokesperson for The Missouri Hospital Association. “Yes, there are certainly some similarities between these states being conservative states, but that doesn’t necessarily mean that we will treat it as Missouri will be a slam dunk.”
In Oklahoma, a majority of voters in just seven of 77 counties favored expansion. However, the proposed amendment garnered strong 60%-plus support in Oklahoma and Tulsa Counties, home to the state’s two most populous cities, Oklahoma City and Tulsa.
Jack Cardetti, a spokesperson for Missouri’s pro-expansion campaign, would not speak to whether his camp is targeting voters in any specific areas.
In Oklahoma, more than 75% of the nearly 73,000 voters who voted early or cast an absentee ballot, supported the expansion amendment.
A new Missouri law expands absentee voting for registered voters who are in “an at-risk category for contracting or transmitting” COVID-19, including anyone age 65 or older.
Even as Republican Gov. Mike Parson remains vocally opposed to Medicaid expansion, a bipartisan coalition supporting the amendment has scored significant endorsements and flexed its fundraising muscles.
State filings show that Missouri’s pro-expansion committee has already raised $3,339,624 this cycle, spending $283,000 last quarter. By contrast, the anti-Medicaid expansion committee, organized on June 4, has yet to report any contributions.
Bob Onder, a state senator from St. Charles County speaking on behalf of the anti-expansion effort, said voters need to know one thing ahead of the referendum: Missouri can’t afford to expand Medicaid.
“The money needed to expand Medicaid is going to come from somewhere. It either has to come from education, from roads or from massive tax increases,” Onder said.
“I do think that Missourians, particularly in these challenging economic times, will realize that a massive expansion of the Medicaid program isn’t something that we can afford.”
Conversely, Dillon said the timing of Missouri’s vote during the COVID-19 crisis underscores the importance of expanding Medicaid access.
“It’s hard to disconnect this issue in the current environment with the growing number of Missouians who have lost jobs — many of which may have had health insurance connected to them,” Dillon said.
In May, 923,000 Missourians were enrolled in Medicaid — up 75,000 from February.
“Now more than ever, Missourians need to be able to access care in their own communities and protect thousands of local frontline healthcare jobs,” Cardetti said. “Amendment 2 will help keep rural hospitals and urban clinics open by bringing $1 billion of our own tax dollars back from Washington, instead of going to the 37 other states that have expanded Medicaid.”
Kansas’s Democratic Gov. Laura Kelly struck a Medicaid expansion deal with key Republican leaders earlier this year, but conservatives thwarted legislative efforts by tying expansion to a rollback of abortion rights.
“The ability to have a referendum and go directly to a vote of the people is really key,” said April Holman, executive director of the Alliance for a Healthy Kansas.
“Even within our House and Senate in the state, we know that we have a majority of legislators who support expansion. We just haven’t been able to get to a clean vote on the issue.”
Holman said she expects the Oklahoma vote to turn up the heat on conservative holdouts in the state legislature.
“I think that it will ramp up pressure, especially in border communities, when people that they know on the other side of the border are able to have this coverage that will help them to afford care,” Holman said.