Missouri voters approved Medicaid Expansion via a state plan amendment last night.
Missouri voters have PASSED Amendment 2, the ballot initiative expanding Medicaid to approximately 230,000 low-income Missouri residents, @DecisionDeskHQ projects. Missouri joins Oklahoma as the second state to expand Medicaid via ballot initiative in 2020 https://t.co/AB2Vrh6lml pic.twitter.com/8OpdLQliW3
— Grace Panetta (@grace_panetta) August 5, 2020
The State Plan Amendment Expansion will go into effect July 1, 2021. The State Plan Amendment means waivers that enable shenanigans like work requirements are not applicable to the expansion. The cities voted strongly for expansion while the suburbs and rural areas voted far less intensely against it than they typically vote against the cities.
12 states including the Big 4 of Texas, Florida, Georgia and North Carolina still have not expanded Medicaid.
Congratulations Missouri for doing something to help your own residents and aid keeping your rural health networks plausibly viable.
Mary G
Hurray for common sense!
Baud
If Missouri would vote Dem, they could have many other nice things too.
cmorenc
All the blue “yes” areas are larger urban areas, with the curious exception of the one isolated one in southwest Missouri – which turns out to be the Branson music resort area, which I would have thought might be more red-ish because of the predominate crowd it caters to.
prufrock
@cmorenc: They probably have lots of workers who would qualify for Medicaid.
jimmiraybob
If you look at the vote distribution it’s mostly urban centers (St. Louis, Columbia, & Kansas City) that account for passage. I suspect that the rural areas that rejected this did so because of the campaign to tie passage into anti-immigrant/foreigner fear and resentment. It’s like rejecting electricity for fear that Not Real Americans might get some. Full disclosure, I am an Urban.
Walker
@cmorenc: The people who actually live in Branson are probably low wage entertainment workers.
p.a.
Now let’s see the ‘no’ votes who qualify abstain from signing up…
Mathguy
Cue GOP sabotage in 3, 2, 1….
cmorenc
@Walker: @prufrock:
Yes, though on superficial first glance the majority “yes” in Branson seems surprising, it makes sense on more thoughtful consideration of what the preponderant local population actually is (modest-earning resort support workers), rather than the composition of the area’s visiting tourists (Yee-haw).
OzarkHillbilly
Consider my gob to be thoroughly smacked. I had seen so little one way or the other I just didn’t think people were even paying attention to it and figured it would die of neglect. Very happy to have been wrong.
karensky
Awesome news!
PsiFighter37
Makes me wonder if there is some possibility Democrats could be competitive statewide again – the vote distribution looks like what a Democrat winning statewide here would look like (basically win St. Louis, KC and the surrounding suburbs).
OzarkHillbilly
The only anti flyer I got said it was the first step on the Obamacare slippery slope to socialized medicine, which to people who can’t afford insurance sounds pretty good.
ETA:<a href=”#comment-7803491″>@PsiFighter37</a>: I suspect Nicole Galloway is rubbing her hands together with her best Snidely Whiplash evil snicker.
low-tech cyclist
There are still 12 holdout states that continue to exclude themselves from the Medicaid expansion.
There are 11 states that were part of the Confederate rebellion.
8 states are in both groups.
Soprano2
If you click on the map you can see that the SWMO county that actually voted for Medicaid expansion was the county of Greene, which is where Springfield is, which is where I live!!! We are the 3rd largest city in Missouri, so not at all surprising. I looked at what you could see of the map on the website and thought “those counties don’t look right”. I would venture a guess that most of the people who work in the Branson tourist industry live in pay-by-the-week motels or RV’s in campgrounds and probably didn’t vote yesterday. Branson is in Taney County, which voted “no”. There will be the usual grumbling that people outvoted land mass once again, LOL. The irony is that the people in rural areas will benefit the most from Medicaid expansion, but because it also benefits “those people” in the cities they voted against it.
p.a.
@low-tech cyclist: Jeff Davis never ever gives up…
OzarkHillbilly
@Soprano2: I have been thinking of our local hospital and how this has probably saved it.
Elizabelle
@low-tech cyclist: I am lazy this morning. Will you please put up the list of the 12 holdouts against Medicaid?
===
Yea Missouri! I thought that might pass, especially during a job-killing pandemic.
And that map, with all the red, but the blue areas provided more votes , reminds me again why we have to get rid of the fucking Electoral College SOONEST.
No EC, no Trump, and reduces the tyranny of the minority (representing those with the majority of the money).
Joe Falco
Bravo. Missouri voters! Now if only Georgia would go blue or at least purple enough to expand. This Confederacy of Dunces can’t be defeated soon enough!
Jharp
So who the fuck votes against health insurance for poor people. And even more unbelievable is it health insurance that is already being paid for.
Something is wrong with us.
Elizabelle
Looked it up myself. From KFF — (which I am guessing is the Kaiser Family Foundation — it’s the majority of the Confederacy plus some outliers. Twelve states, that should do so much better. Maybe North Carolina will.
Here are the holdouts:
The freedom loving, socialism-hatin’ north, with Brownbackistan thrown in: Wisconsin, Kansas, Wyoming, South Dakota.
Texas Fucking Texas
and the old South, although a few states have wised up (proud of you, Louisiana and Arkansas):
North Carolina
Tennessee
South Carolina
Georgia
Alabama
Mississippi
Florida.
The three states that voted for the expansion, but not implemented yet:
Missouri — 3 cheers!
Oklahoma
Nebraska
OzarkHillbilly
Embittered rural white people.
Mart
The ads fed to us on Spectrum cable must know we are blue. I thought they were very smart, never mentioning Obamacare, and emphasizing all the tax $$ we are not getting for our healthcare. Many ads were reverse engineered Red scare type ads. Glad to be on the winning side, it’s been awhile.
Elizabelle
KFF’s Chart of the Week: U.S. Has Higher Number of COVID-19 Cases per Capita Compared to Other Countries That Reopened Schools
The five nations, with the most cases per capita:
United States of Trump 196.96
Denmark 35.5
Belgium 25.1
Norway 17.2
France 17.0
Brachiator
It seems strange that rural areas would vote against Medicaid expansion despite an apparent need for assistance. How else do they propose helping rural health networks?
Marcopolo
@Mathguy: As I said in a post last night, the ballot initiative that passed yesterday in MO was a constitutional amendment. So Medicaid expansion is now included in the MO Constitution. If Gov Parsons or the R legislature wants to try to sabotage this they will be hit with numerous lawsuits. For example, adding in a work requirement is against the Constitution now.
I’m totally happy Medicaid expansion passed but even more happy that St. Louis & St. Louis City have now sent the first AA woman in MO history on her way to Congress. And she wasn’t a previous office holder. And she was poor (single mom, evicted 3x). I have no idea how she will do but the life experience she brings to Congress will be a breath of fresh air.
OzarkHillbilly
@Elizabelle: We’re #1! We’re #1! We’re #1! We’re #1!
OzarkHillbilly
Well that’s easy. Their hospitals and clinics would never close. That only happens to those people.
Ken
@OzarkHillbilly: We’re last. That means we’re first.
That Axios interview is an incredible meme factory.
Marcopolo
@Brachiator: It’s just hyper-partisanship. As recently as 2012 (when McCaskill won her second Senate race) there were still folks in rural MO who would consider splitting their tickets between Rs & Ds but no longer. It is almost inconceivable that Obama almost won MO in 2008 (lost by ~4,000 votes). Apparently having a black president caused a lot of less educated, economically challenged white folks to lose their goddamned minds.
And honestly, if you are a person who wants to do something with your life and you are living in rural MO you get the hell out as fast as you can so the cycle is self-perpetuating. I’m not even sure who still lives in these areas that could/would be making the argument that the only way for rural health care in MO to survive was to pass the Medicaid expansion (which is absolutely true). Maybe local healthcare workers but over the past 8-10 years a bunch of rural hospitals have shut down so even those folks are few and far between.
I will note, however that both medical mary jane and opposition to Right to Work seem to overcome this partisanship–ballot initiatives on both these issues passed overwhelmingly statewide in 2018.
OzarkHillbilly
@Ken: I feel like I should watch but then I remember trump, and I start gagging all over again.
Mike J
I was reading that suburban St Louis went +25 points for Romney, +9 for Trump, and split 50-50 on Medicaid expansion. Let’s hope they’re wising up.
RobertDSC-Work
I’m glad.
Marcopolo
@Mike J: In 2016 St. Louis County went 55-39 for Clinton. Your info is bad.
OzarkHillbilly
@Mike J: I suspect it’s not so much wising up as it is the right wingers are moving to the more friendly confines of St Charles, Jefferson, and Franklin counties.
OzarkHillbilly
@Marcopolo: Suburban STL includes St Charles, northern Jefferson, and eastern Franklin counties. Technically it also includes portions of metro east but I doubt those numbers get included.
L85NJGT
@Mike J:
MO-2 looks like a flip.
The suburban rural trade for the GOP was a terrible idea, with only a few states where that wouldn’t be to a Democratic advantage.
BC in Illinois
@L85NJGT:
I’m fairly hopeful for a flip this year. As I said in an earlier thread:
Ann Wagner consistently tries to stay out of the public eye, serve her corporate sponsors, and be, in general, forgotten, but not gone. She won by only 4% in 2018. This may be the year of her departure.
L85NJGT
@OzarkHillbilly:
St Charles was 51/49 yes, Jefferson 46/54 no. The GOP used to run up 40 point advantages in the suburban edge.
MomSense
Congratulations, MO!!
We had to take matters into our own hands to expand Medicaid here in Maine, too.
OzarkHillbilly
DOH! You’re right, that surprises me I thought it was still bleeding GOP red. Jeffco… I don’t see it turning true blue for quite some time. They might vote against the disaster that is trump but I would bet they will revert to form in 4 years.
L85NJGT
A deal in Kansas got blow up by GOP revanchists in the state lege, and a Florida ballot initiative will get voted on in 2022.
Comrade Misfit
The same thing happened two years ago when Missouri voters overturned the GOP’s “Right to Slavery” (aka “right to work”) law. That was by about 2-1.
Marcopolo
@BC in Illinois: Yeah, I think the numbers last night portend a flip in MO-2. I think there will be some state house/state senate seats in the MO-2 area that will also flip. Maybe enough to end the GOP legislative supermajority. That would be nice.
If that happens, celebrate it now. MO will be losing a US House seat in 2022 and I am pretty sure all attempts will be made to get rid of a D leaning/Purple district.
As for shifting demographics, I can remember when St Louis County was a Republican place. St. Charles County is already trending purple, give it another decade or two. As for Jeff Co, well, it will be more red/purple than true outback rural MO (can you day Christian County?) going forward but I think it may be a little too far out from St Louis to ever elect Dems again. But who knows, maybe fallout from Trump will nuke the R party. A man can hope.
SFAW
@Elizabelle:
KFF needs a headline editor what talks English good.
If SubaruDianne weren’t still hungover from her birthday revelry, I’d ask her to write them a sternly-worded letter. Or SteveintheWherever. [Steve’s OK, right? I know he was going to take some time away from here, but thought I best ask.]
Marcopolo
@OzarkHillbilly: We will disagree on the definition of suburban St Louis. St. Charles, MO is and has always been St. Charles, MO, not a suburb of St Louis. That would be like saying either Minneapolis or St. Paul is a suburb of the other. I’ll accept great St Louis metropolitan region to include the areas you mention but definitely not the term suburb.
Uncle Cosmo
Mmm…got a plan for that? Since the EC is enshrined in the Constitution & all (Article II, Section 1, Clause 3, as revised in the Twelfth and Twentieth Amendments)? Think we can get an Amendment past 2/3 of both houses of Congress when at least 1/3 of the states now benefit from the misallocation of electoral power? Or get it past an Article V constitutional convention called by 2/3 of state legislatures (with all the potential unrelated populist/neofascist mayhem therein)? And then ratified by 3/4 of the state legislatures?
Don’t think so.
Best shot appears to be signing up states to the National Popular Vote Interstate Compact to reach the magic number of 270 EVs, at which point it takes effect.** Though there’s some question as to whether the Compact would be found constitutional when (not if) challenged in court. Maybe we should pack the friggin’ courts first…at least issue a thinly-veiled credible threat to pack them should the Compact be overturned.
** Currently enacted in states with 196 EVs and pending in states with 64 EVs. I am proud to note that my home state of MD was the first to join, the bill signed into law by my long-time friend then-Gov. Martin O’Malley on 10 April 2007.
Shawn in ShowMe
@OzarkHillbilly:
Exactly. According the U.S. Census, St. Charles County had the biggest gain in population in the area from 2017 to 2018, while the population of St. Louis County remained the same.
St Louis Post Dispatch (behind paywall)
Elizabelle
@Uncle Cosmo: Whatever. It has to go. It distorts the process.
I realize the Founders made it hard to kill, with the vote by states provision, which enshrines it. However we get there, the EC has got to go. Period.
Shawn in ShowMe
@Marcopolo:
Since I moved back to the Midwest 25 years ago, I’ve noticed that big city Missourians make a much bigger deal about the cultural difference of outlying areas than I think is warranted. Many of the families in St. Charles County started out in other areas of St. Louis metro in the first place. It’s only 30 min from downtown St. Louis.
Marcopolo
@Shawn in ShowMe: Not sure what your point is. Yes, a lot of folks moved out of St. Louis County to St. Charles because they wanted to get away from “the blacks.” These are the same folks who moved out of St. Louis City to St. Louis County from the 1950s to 1980s for the same reason.
What I was focused on was the use of the term suburb, which is the term Mike J used. As someone who grew up in an inner ring suburb of St Louis, I can tell you no one here considers areas outside of St Louis County a suburb of St Louis. As I said above, St Charles, which was founded in 1769 has always been considered a separate municipality, located on the other side of the Missouri river. Now that it has grown in population it has its own suburbs. If you want to call it the exurbs I guess you could do that. If you want to include areas like St. Charles County, Jefferson County, Madison County (IL), etc and say it is the greater St Louis metropolitan area/region, the bi-state area, etc… fine, but I’m a bit of a stickler when you attribute election results to “suburbs” but are actually talking about a much larger area.
dopey-o
St Charles County was the destination for White Flight for many years, and altho it is becoming more diverse, it seems to be a long way from turning as blue as St.Louis County.
Many years ago in St Louis i saw a bumper sticker that proclaimed “Jefferson Couny – 40,000 hogs can’t be wrong!” In more. recent years, Jefferson County has been known for meth labs. Most of Jeff Co is still part of the Confederacy IMHO.
PaulWartenberg
I find it interesting that in nearly every Red state that allows for voter referendums on Medicaid Expansion, the referendum usually passes. I can’t recall a referendum losing on the ballot.
It’s as though the people know they need that health care safety net, but the GOP party leadership is too partisan and wingnut to admit it and pass their own legislation to do it.
Soprano2
@OzarkHillbilly: Yep, poor white people in rural areas who are convinced that Medicaid helps those black people in the cities have 10 babies each.
jimmiraybob
Well, you know the old saying, “as soon as the family has reliable healthcare they will start worshiping Karl Marx.”
Soprano2
@Marcopolo: “True outback rural” in SWMO is more like Douglas or Taney County. Christian is getting more and more populous as Ozark and Nixa grow and grow. Ozark has over 20,000 residents and Nixa has almost 22,000 (Nixa is bigger than Ozark, who knew?). In 1980 Nixa had 2,662 people and Ozark had almost 8,000 people. I predict that if I live 20 more years Ozark and Nixa will grow into Springfield. Right now they’re only a mile or two apart.
Mike J
@Marcopolo: Suburban, meaning St Charles. St Louis county always goes Dem.
mdblanche
Reminds me of “It’s a Wonderful Life” where George Bailey single-handedly saves Bedford Falls from turning into Pottersville, but he’s only around to do it because fate wrecked all his attempts to leave.
rikyrah
Happy for my fellow citizens :)
I'll be Frank
@Marcopolo: It’s not that they lost their minds, it’s that in their minds it is NOT a possibility that the blah guy could do better, so all Trump has to do is keep saying he’s doing better and he is. What he actually does is irrelevant.
WaterGirl
@I’ll be Frank: Your comment went into moderation because WordPress does not link apostrophes in screen names (nyms).
I released this particular comment, but I expect that every comment you post will need to be manually released until your nym does not contain an apostrophe.
Ken
Then there was that transitional period, when on every road south from St. Louis County you could tell the moment you crossed into Jefferson County, because of the cluster of (ahem) massage parlors.
janesays
@cmorenc: The SW area you’re looking at is Springfield, MO. It’s the 3rd largest city in the state and a college town (Missouri State University). Branson is about 45 miles directly south of Springfield, 15 miles from the Arkansas border.
TriassicSands
Now just hold on. Look at that map. According to the Republican theory of voting, the formula is not one person one vote, but rather one acre one vote. By that standard, Medicaid was overwhelmingly defeated. Reporting live from the asylum.
Soprano2
@TriassicSands: I’m sure there will be a letter to the editor of my paper saying just that in the next couple of weeks. They think square miles should vote.
janesays
@Mike J:
St. Louis City went 88-12 for Medicaid expansion.
St. Louis County – which makes up the bulk of the St. Louis suburbs – went 73-27 for Medicaid expansion.
Neighboring St. Charles County, which is decidedly more conservative, went 51-49 for Medicaid expansion.
Those three entities make up 2/3 of the entire metropolitan population of Greater St. Louis.
janesays
@OzarkHillbilly: The metro east didn’t include those numbers because there were no numbers to include. It’s in a different state, Illinois.
janesays
@OzarkHillbilly: St. Charles is still decidedly a pretty red area and will vote overwhelmingly for Wagner and Luetkemeyer (it’s split between two congressional districts), but it’s gotten less red than it used to be, and very much less red than Jefferson and Franklin Counties.
If we flip MO-02, it will be St. Louis County that does it, because more than 2/3 of that district’s voters live there
There’s absolutely no chance in hell Jeffco flips against Trump. He won it by 35 points in 2016.
janesays
@Marcopolo: Missouri is not expected to lose a congressional district in reapportionment according to everything I’ve read. Our population didn’t increase at the same rate as the nation overall, but it did increase by about 2.5%.
Election Data Services projects that Rhode Island, West Virginia, Minnesota, Michigan, Ohio, Pennsylvania, New York, Alabama, Illinois and California (yes, California) will each lose one house seat, while Texas, Florida, Arizona, Colorado, Oregon, North Carolina and Montana are all expected to gain one or more seats.
https://www.politico.com/news/2019/12/30/redistricting-house-2020-091451
Yutsano
@Uncle Cosmo: There’s a fun video about it. It’s a touch out of date but still.
janesays
Question about 10 year redistricting – does it occur nationwide, or only in the states that have lost or gained congressional seats? Specifically, if you live in a state that neither gains nor loses seats, will the congressional district lines still get redrawn?
Geminid
I hope no one is assuming that the republicans will never win the popular vote and lose what would have been the electoral vote. It could have happened in 2000, and almost happened in 2004. Current trends say it won’t happen, but trends are dynamic, not static. And if the presidency is awarded by popular vote, there will have to be a runoff, as there will probably be 3 to 5 party candidates and at least two multibillionaire independents. On election night, they’ll have weight poor Steve Kornacki down, like they do with jockeys.
Ken
@janesays: Usually redistricting is required because the in-state distribution has changed. The districts in a state all have to have approximately the same population.