The Gateway to Better Health program was designed to provide uninsured adults a bridge in care until they were able to enroll in health insurance coverage options available through the Affordable Care Act. It served as a temporary health care program for uninsured adults across St. Louis City and County.

The program covered primary, specialty, and urgent care services for individuals earning up to 100% of the Federal Poverty Level.

In August 2020, Missouri voters approved Medicaid expansion!

This meant that residents across the region who were covered under the Gateway to Better Health program, would now likely qualify for Medicaid benefits under this new state-wide policy change. The review process to transition Gateway members to appropriate forms of Medicaid coverage began October 1, 2021 (see the RHC blog for more information).

The Gateway program concluded on December 31, 2022 with all members successfully converting to full insurance coverage!

What does Medicaid expansion cover?

Check out the RHC’s CoverSTL page for information on what this means for Gateway to Better Health patients and other residents across the state.

Health Literacy Media also developed content to help consumers understand these changes to Medicaid services. Short videos are available here at They address:

  • What is Medicaid expansion in Missouri?
  • Do I qualify for Medicaid now that it expanded?
  • Ways to apply for Medicaid
  • And getting free help to apply for Medicaid

Need help applying?

View the RHC’s application assistor map to locate in-person and virtual assistance, or call the Medicaid Expansion HelpLine at 1-888-686-1744.

What do our Patients and Providers say?

93% of providers believe that the overall health of Gateway enrollees has improved since enrolling in Gateway.

94% of all patients would recommend their health center to family members or friends.

71% of patients reported improved overall physical health since enrolling in the Gateway program.

“Before I had insurance through Gateway, I would not go to the doctor. Now that I do have insurance, I don’t have to be afraid to call and go to the doctor.”

Gateway to Better Health Patient

Lifetime Impact of the Gateway Demonstration

Members enrolled

Medical claims

Primary care and dental visits

Medications to manage chronic conditions and other diseases

Specialty care visits

Diagnostic tests, procedures, and ancillary services

Urgent care visits

Additional Information


To learn more about Gateway to Better Health, please contact Riisa Rawlins.