Medicaid expansion OKd by voters in Missouri was opposed by most voters in rural areas, but it may help them most

Kaiser Family Foundation map, adapted by The Rural Blog

"Missouri recently became the fifth straight red state to approve Medicaid expansion by referendum, joining Idaho, Nebraska, Utah and Oklahoma," former Minnesota senator Al Franken, a Democrat, notes in an op-ed for the StarTribune in Minneapolis.

Franken writes that he's unsurprised by the trend, since during his Senate career, he saw many rural Minnesotans who were "passionate" about Medicaid expansion. However, in Missouri, the largest state to expand Medicaid by referendum, the measure passed because of urban support; two-thirds of rural voters opposed it, Bill Bishop and Tim Marema report for The Daily Yonder.

Franken writes that Medicaid expansion will disproportionately help rural residents, as it has done in Minnesota. "After the Affordable Care Act became law and Medicaid expansion was adopted in our state, these hospitals suddenly found themselves with a lot less uncompensated care and, therefore, a lot more resources," Franken writes. Now that rural hospitals didn’t have to eat the costs of uninsured patients, they had money they could spend for more doctors, nurses, technicians, technology, rehabilitation therapists, dietitians — even better food! Suddenly, these rural hospitals were able to significantly expand their scope of practice."

Expanded access to health care may help fewer people get sick with covid-19, he continues: "Not only did rural Minnesotans have access to more specialists and sophisticated medical equipment (including ventilators), now they could receive regular free checkups from their physicians, reducing the incidence and severity of the co-morbidities that make people so vulnerable to the coronavirus."