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Missouri has not expanded Medicaid (MO Health Net) under the Affordable Care Act (ACA).
Non-disabled adults without children are not eligible for Medicaid regardless of how low their income is, and parents with dependent children are only eligible with incomes that don’t exceed 22 percent of the poverty level.
Missouri does not allow non-disabled, childless adults to enroll in Medicaid, regardless of how low their income is.
And parents with dependent children are only eligible for Medicaid with income up to 22 percent of the poverty level, which amounts to about 1 per month for a household of three people in 2018.
But in 2012, the Supreme Court ruled that states could not be penalized for opting out of expansion, and Missouri is one of 19 states that have not yet expanded coverage.
Only Texas and Alabama have lower Medicaid eligibility caps, at 18 percent.
If Missouri had expanded Medicaid, Families USA estimates that 293,000 people would be newly eligible for coverage.
A spokesperson for the Missouri Department of Social Services said that enrollment had been trending downward for some time.
But by January 2018, total enrollment in CHIP and MO Health Net had grown to 959,354 people – an increase of 13 percent since the fall of 2013.
Because subsidies are only available in the exchange for people whose household incomes are at least 100 percent of poverty (since Medicaid was supposed to be available for those below that level), there are 87,000 people in Missouri who are in the coverage gap and have no realistic access to health insurance.