St. Louis City Senior Fund Supports Medicaid Expansion in Missouri

The St. Louis City Senior Fund joins a coalition of more than 250 organizations endorsing Medicaid expansion in Missouri. Currently, Missouri is one of 13 states that has not expanded Medicaid under provisions from the Affordable Care Act, making it difficult for many residents to receive much needed health insurance coverage, especially during the current COVID-19 pandemic.

Expanding MO HealthNet, Missouri’s Medicaid program, would provide health insurance coverage to 230,000 Missourians who are now caught in a coverage gap—they earn too much to qualify for the current Medicaid program but not enough to afford health coverage on their own.1-2

Figure Shows Gap in Coverage for Adults in States that Do Not Expand Medicaid Under the ACA. Source: Kaiser Family Foundation.

Missouri adults currently only qualify for Medicaid if:

  • They are a parent with children and their annual income is below 22% Federal Poverty Level (FPL);
  • They have certain disabilities and have an annual income below 85% FPL;
  • They are blind and have an annual income below 100% FPL; or
  • They are 65 years or older and have an annual income below 120% FPL.3

Health insurance provides financial security for Missourians so they can work, contribute to their communities, and take care of themselves and their families. By expanding MO HealthNet to any adult with an income less than 138% FPL, an adult who makes up to $18,000 per year would be eligible for healthcare coverage.

Medicaid Expansion Will Benefit Older Missourians

While some people may think Medicaid expansion primarily benefits younger residents, it is estimated that 18,000 older Missourians between the ages of 50-64— most of whom are working—will also benefit from expansion.4

For older residents who do not have access to affordable healthcare coverage, but are too young to qualify for Medicare, Medicaid expansion can provide much needed services. Not receiving needed healthcare can limit a person’s ability to work and sometimes lead to premature retirement. It also allows health conditions and impairments to become more serious and more costly to treat when these individuals become eligible for Medicare at age 65.5 Medicaid expansion can improve access to care and health outcomes, extending healthy lives for middle-aged and older Missourians.

Medicaid Expansion Will Free up State Dollars for Other Needs

Expanding Medicaid will bring federal funds paid by residents through taxes back to Missouri. Current state spending on needs that will be covered under Medicaid expansion will be offset by these federal dollars, freeing up state funding to cover other priorities.1

As Missourians face the catastrophic health and economic consequences of the COVID-19 pandemic, demand for safety net services and other support has significantly increased. Many essential services for older residents are funded in part through the state’s general revenue—and are currently at risk of being cut. Medicaid expansion will provide an opportunity for more state funding to be directed to support essential community-based services such as those that allow older adults to remain living independently in their communities.

Expanding Missouri’s Medicaid program will provide access to affordable healthcare coverage for many older residents, bring taxpayer dollars back home, and save state funding. Expansion will also create jobs and help keep rural hospitals open. No matter how you look at it, expanding Medicaid in Missouri makes sense.

The St. Louis City Senior Fund supports Medicaid expansion in Missouri. You can vote on expanding Medicaid on August 4, 2020.

To learn more about Medicaid expansion in Missouri, visit

This statement was developed by Reese Moore, Graduate Intern at St. Louis City Senior Fund & Graduate Research Assistant at Scripps Gerontology Center, Miami University.

1 “Makes Sense MO.” Missouri Foundation for Health,
2 Garfield R, Orgera K, Damico A. “The Coverage Gap: Uninsured Poor Adults in States that Do Not Expand Medicaid.” Kaiser Family Foundation, January 2020,
3 “Health Care – MO HealthNet (Medicaid).” Missouri Department of Social Services,
4 “AARP Missouri Endorses Amendment 2 Medicaid Expansion Ballot Initiative.” AARP Missouri,
5 Sass, S. “How Medicaid Helps Older Americans.” Center for Retirement Research at Boston College, March 2018,