Medicaid Expansion Update | June 11, 2020

June 11, 2020

June 11, 2020

As we begin the eight-week sprint to success on Aug. 4 to expand Medicaid for 230,000 hardworking Missourians, there’s a lot of work to be done. MHA will be sharing campaign updates and resources with you weekly, and we encourage you to use them in your hospital and community to promote the importance of expansion to our state.


Last week, the Missouri Chamber of Commerce and Industry board unanimously voted to endorse Medicaid expansion. They now will be reaching out to local chambers throughout the state to promote the importance of expansion in local communities.



A new report released Tuesday by the Missouri Foundation for Health shows the projected impact of Medicaid expansion on Missouri’s economy from 2022-2026. The report details broad, statewide economic benefits to expanding Missouri’s Medicaid program. Highlights include an average increase of more than 16,000 new jobs each year and extensive gains in jobs outside of the Kansas City and St. Louis metropolitan areas. An infographic summarizes the report’s findings.



Medicaid Expansion Fact Sheet Image
A PowerPoint presentation and fact sheet have been developed to use in your hospital and community about the importance of expansion. Hospitals can customize these materials as needed. Talking points and fact sheets also are available on MHA's Medicaid expansion web page on the following topics.

  • How expansion would help in the COVID-19 pandemic.
  • How hospital community benefit and charity care would be affected by expansion.
  • The boost to the state’s economy that will result from expansion, as researched in a study by Health Management Associates.
  • A map showing rural hospital closures, in addition to facts about rural hospitals in Missouri.

In the next couple of weeks, watch for additional tools you can use in your internal and external efforts, as well as a supply of postcards that can be shared with employees, volunteers and physicians.



The Healthcare for Missouri campaign activity in endorsements, earned media and engagement will be coordinated around the following themes. MHA will share materials you can use to promote these themes in your hospital and community.

Week 8 – June 8: Missouri Business Week – economic impact report/Chamber endorsement
Week 7 – June 15: Seniors for Expansion – AARP endorsement and their campaign
Week 6 – June 22: Labor group endorsements
Week 5 – June 29: First responders – EMS, firefighters
Week 4 – July 6: Veterans
Week 3 – July 13: Rural hospitals/women’s health care
Week 2 – July 20: 230,000 hardworking Missourians/Faith voices
Week 1 – July 27: More important than ever before – motivate base voters with human impact



On Monday, a state appeals court turned back an attempt by two conservative groups to stop the ballot proposal. The Missouri Western District Court of Appeals said an earlier decision by Cole County Circuit Judge Daniel Green to dismiss the lawsuit was correct. Subsequently, the Missouri Supreme Court denied transfer of the case, which ends the litigation to remove the issue from the August ballot.



The campaign is preparing for the potential of organized opposition to the ballot initiative. A "No on 2 in August" committee recently was formed. Consultants with the campaign are working to tamp down opposition, but it is unclear whether and how well-funded such opposition will be.



With the expectation there will be organized opposition, paid media will begin in mid-June — a bit earlier and stronger than originally anticipated. Three universes will be targeted — it will be important to talk to these groups as much as possible.

  • Get Out The Vote – those who need a reminder to vote
  • Retention – soft supporters
  • Persuasion – soft opponents

Digital ads will begin as soon as possible. Television ads will begin after July 4. There will be targeted mail and digital for specific subgroups. And the campaign will encourage people to vote absentee when possible.



Washington University health economist Tim McBride has developed an estimate of how the roughly 231,000 adults eligible to enroll under Medicaid expansion would be distributed throughout the state by region and county.



MARV Stops at Washington County Memorial HospitalIron County Medical Center in Pilot Knob and Washington County Memorial Hospital in Potosi both hosted the Medicaid Ambulance Response Vehicle, or MARV, to spotlight the need for Medicaid expansion in Missouri. The MARV is part of the Healthcare for Missouri campaign to adopt the measure by initiative on the Aug. 4 ballot.

In a Facebook post announcing the visit, Iron County Medical Center said the following.

“Missourians will now vote on Medicaid expansion on August 4 rather than in the fall. The date change makes it that much more vital to spread our message and win this campaign.

MARV Stops at Iron County Hospital It’s even more urgent now that we expand Medicaid to keep our rural hospitals open, protect Missouri jobs, bring billions of our tax dollars home from Washington, and help hundreds of thousands of hardworking Missourians and their families gain coverage.

We’re taking a stand to put Missouri families first. Together, we will win on Aug. 4 to deliver life-saving care for over 230,000 Missourians.”



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