Want the best of VICE News straight to your inbox? Sign up here.Missouri just became the sixth red state where voters decided to provide greater health care coverage to the poor by expanding Medicaid, despite Republicans’ resistance to the Obamacare program.On Tuesday, voters in the Republican-controlled state approved a ballot initiative by 53% that adds the program into the state’s constitution. The change ensures care for as many as 231,000 adults who might’ve otherwise gone without health insurance, which can be prohibitively expensive.In states without Medicaid expansion, like Texas, it can be virtually impossible to qualify for the program unless you’re pregnant, an extremely low-income parent, or deeply ill and disabled. In Missouri, childless, non-disabled adults can’t qualify for Medicaid, regardless of their income level.The 2010 Affordable Care Act sought to bring more people into the tent by allowing adults who make up to 138% of the federal poverty level each year to qualify for the largely popular program. In a Medicaid expansion state, a family of four would qualify this year if they made $36,156 or less.That broader qualification could be especially important now, since millions of Americans have lost both their jobs and the health insurance plans that were tied to them during the COVID-19 pandemic. Missouri is the second state to expand Medicaid since the virus started swepeping the nation; Oklahomans decided to expand Medicaid via ballot initiative in June.But many Republican states continue to reject the program, even as data has shown that it’s benefited cancer patients, rural hospitals fighting against closure, and families facing economic insecurity and medical debt. There are only 12 states left that haven’t expanded Medicaid — and most are led by Republicans in the South, in states with some of the worst health-care outcomes in the nation. A 2012 Supreme Court decision left it up to the states to determine whether to expand Medicaid.Missouri’s program will take effect by July 2021, and Gov. Mike Parson had previously said he’d adhere to whatever voters approved on Medicaid, according to the St. Louis Post-Dispatch, although he personally opposes expansion and worries it’ll be costly.A coalition of Republican attorneys general, including Missouri’s, has asked the Supreme Court to gut the entire Affordable Care Act, which would endanger Medicaid expansion nationwide and health insurance coverage for more than 23 million people. Their fight is supported by the Trump administration, which has declined to defend the federal law in court.President Donald Trump said he’d introduce some sort of replacement program at the beginning of this month but has so far failed to do so, leaving Americans in the lurch if Obamacare is struck down.Cover: FILE - In this July 7, 2020, file photo, Missouri Gov. Mike Parson speaks during an event at the White House, in Washington. (AP Photo/Alex Brandon, File)
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