Missouri this week became the seventh state to approve Obamacare’s Medicaid expansion since President Donald Trump took office, The Associated Press reports.
Most of the states that have expanded Medicaid have been red states even though Trump continues to fight to dismantle the Obamacare law in its entirety.
Missouri voters approved the Medicaid expansion 53-47 despite opposition from the state’s Republican governor.
Missouri’s expansion leaves only a dozen states that have not expanded Medicaid under the Affordable Care Act, leaving millions without health coverage.
But even opponents of the expansion like former Trump health adviser Brian Blase expect more states to follow suit.
"Medicaid expansion is terrible policy, but it is attractive to states because it's almost all federal spending and the insurance companies and hospitals get lots of dollars when a state expands Medicaid," he said. “There's lots of political pressure to expand," said Blase. "Eventually all states are going to expand unless the enhanced (federal) match rate changes."
Red states rush to expand:
Before Missouri’s vote, Oklahoma approved a Medicaid expansion by a similarly close margin.
Idaho, Maine, Nebraska, and Utah voters have all voted to expand the program as well.
Virginia’s state legislature approved its Medicaid expansion after Democrats won a majority of the state legislature.
"This is an indication that there is large popular support for providing health care coverage for low-income people, and it is quite possible that this support has increased given what's going on with the pandemic," Rachel Garfield, a senior policy expert with the nonpartisan Kaiser Family Foundation, told the AP.
Suburbs support more than rural areas that need it most:
Though the Medicaid expansion would ostensibly help low-income folks in rural areas, many voters in Missouri’s rural areas opposed the expansion but it was not enough to overcome support from cities and suburbs.
Supporters have pushed for Medicaid expansion since the coronavirus pandemic began. About 4.5 million poor adults live in states that have not expanded Medicaid.
"Those people have no access to coverage," Cindy Mann, who ran Medicaid under President Obama, told the AP. "Those are a lot of the so-called essential workers, if we think about it through the COVID lens. It's a really inequitable story and one that increasingly can't be tolerated by the public."