Why the RHC supports Medicaid expansion


As part of our mission to increase access to health care, reduce health disparities, improve health outcomes in the St. Louis region, and support the health care safety net, the RHC supports expanding Medicaid and voting YES ON 2 on August 4th.

Through its program called Gateway to Better Health (GBH), the RHC has already demonstrated that Medicaid expansion has the potential to provide the following benefits to our region:

  • GBH has improved access to health care services. Without GBH, patients could not keep their overall health the same, access quality medical care, afford prescription medicines, afford to see a primary care doctor, and afford to see a specialist doctor. [1]
  • Medicaid expansion would provide even greater access to health care to people across Missouri.  Expansion would provide access to health care to more than 230,000 Missourians, including people with chronic diseases, such as diabetes and asthma.[2] Expansion would cover adults earning less than $18,000 per year. Many of these individuals now have no option for health care coverage because they do not qualify for Medicaid or for subsidies under the Affordable Care Act. Currently, almost 100,000 people are uninsured in the St. Louis region, meaning 1 in 10 do not have health coverage.[3]

[1] Gateway to Better Health 2019 Patient and Provider Satisfaction Surveys

[2] Kaiser Family Foundation – The coverage gap: uninsured poor adults in states that do not expand Medicaid  

[3] Access to Care 2019 Data Book

  • GBH improved health outcomes for its patients with chronic diseases, like diabetes. [1] Additionally, almost all GBH doctors and patients report improvements in health of GBH patients since enrolling in the program.7
  • Medicaid expansion could further improve health outcomes across Missouri and reduce overall mortality.[2] The nation would have had 15,600 fewer deaths if all states had expanded Medicaid from the start.[3]

[1] Gateway to Better Health Pay for Performance Metrics (community health center electronic medical records) 

[2] Kaiser Family Foundation – The effects of Medicaid expansion under the ACA: updated findings from a literature review  

[3] The National Bureau of Economic Research – Medicaid and mortality: new evidence from linked survey and administrative data

  • One of the core objectives of GBH is to reduce health disparities in our region. The majority of GBH patients, who would otherwise not have access to the same level of quality health care, identify as African American.
  • Medicaid expansion would provide an additional 36,000 African Americans with health care coverage. [1]  Expansion would also reduce disparities in health outcomes. For example, expansion is associated with a significant reduction in disparities for rates of preterm birth (a predictor of infant mortality) for black infants compared with white infants. [2]

[1] Healthcare for Missouri

[2] Kaiser Family Foundation – The effects of Medicaid expansion under the ACA: updated findings from a literature review  

  • GBH has supported our community health centers (CHCs) and urban hospitals serve the most vulnerable populations in our region. At St. Louis community health centers, 1 in 3 patients are uninsured, which financially strains the organizations. [1]
  • Medicaid expansion would help keep CHCs open by providing even greater coverage than GBH. Additionally, since 2014, 15 hospitals in Missouri have closed, forcing people to drive longer distances to reach a hospital when experiencing a medical emergency.[2] Medicaid expansion would protect access to health care across our state, including the St. Louis region.

[1] Access to Care 2019 Data Book

[2] Missouri Health Association – Missouri Hospital Closures

Take action


How you can help pass Medicaid expansion in Missouri?

Vote safe


How you can vote safely on August 4th?

There are three options for voting in the August 4th election: mail-in ballot, absentee ballot, and in-person voting. The deadline to request an absentee or mail-in ballot is July 22, 2020. If you plan to vote in person, here are six ways to stay safe and limit your risk of spreading COVID-19 while voting: