Blog Center for Advancing Health Services, Policy & Economics Research

Medicaid expansion enrollment hits 220,000 on vote anniversary

Written by Timothy McBride, PhD, MS, Bernard Becker Professor at the Brown School and co-director of the Center for Health Economics & Policy at the Institute for Public Health


Roughly two years after the passage of the ballot initiative, and ten months after expansion enrollment began, according to figures from the State of Missouri, enrollment in the Medicaid expansion has hit 220,425 adults. This represents a significant increase of 28,229 in the adult expansion group since August 1 (see Figure 1).

The recent increase in enrollment in the Medicaid expansion represents a significant development in the implementation of the expansion. Before expansion started, the state predicted that roughly 274,000 would be enrolled; ten months into the expansion the state is getting closer to that expectation.

Since expansion was approved by the courts in July 2021, over 242,000 adults have applied for the expansion through the state systems.  The Center for Health Economics and Policy (CHEP) is tracking the development of the expansion over time using a Missouri Medicaid Enrollment Dashboard, with a focus on enrollment by type of recipient, by region, by county, applications to the program, and enrollment in managed care plans.

The volume of applications has led to a significant backlog in pending applications. As of the end of June, the state has taken an average of 115 days to process applications, and 48,200 applications were pending; however, as of August 16, that wait list of pending applications was under 30,000.  A mitigation plan implemented by the State of Missouri on July 11, in consolidation with the Centers for Medicare and Medicaid Services, may be helping to reduce the wait list.

The Center for Health Economics and Policy has also produced policy briefs,  discussing the implementation of Medicaid expansion in Missouri, including the potential impact that expansion is expected to have on the number of Missouri Medicaid enrollees, and the demographics and health status of newly eligible Medicaid beneficiaries.