Yes! to Medicaid Expansion in Missouri: Lessons from the Campaign That Won the Ballot Initiative

In 2020, Missourians voted to join 37 other states in expanding health insurance access to hundreds of thousands of uninsured and underinsured citizens through the Medicaid program. The ballot initiative victory was the culmination of a story that involved the planning and hard work of numerous advocates, endorsers, and institutions. Ballot initiatives are increasingly used as an effective tool to advance legislation in response to voters’ wishes. The Medicaid expansion effort in Missouri is a particularly useful case study for advocates pursuing change through this approach as advocates in the state have a track record of advancing legislation through the ballot and this initiative received unprecedented depth and breadth of support from groups across the state, providing a crucial learning ground for future multistakeholder efforts within and outside of Missouri. Missouri Foundation for Health, long a proponent of improving healthcare quality and access, wanted to ensure this story was told. They partnered with Innovation Network to document the process that led to the victory, and to lift up learning that supports health advocates within Missouri and other states to become even more effective in their work.