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KANSAS CITY, Mo. — The Associated Press says that voters approved Missouri’s Amendment 2 in a call made late Tuesday night, meaning that Medicaid will be expanded. After early returns showed the measure winning decisively, the race got extremely close as the night progressed, the AP calling it with about 85% of the vote processed.

The amendment to the state’s constitution expands Medicaid to include residents between the ages of 19 and 64 – whose income is at or below 138% of the federal poverty level. That’s about $17,600 for an individual or $30,000 for a family of three.

Supporters said more than 200,000 Missourians would gain access to health care.

The state’s Medicaid program currently does not cover most adults without children, and its income eligibility threshold for parents is one of the lowest in the nation at about one-fifth of the poverty level.

But Missouri’s Republican-led Legislature has repeatedly rejected Medicaid expansion proposals over the past decade, prompting supporters to turn to the initiative process.

By proposing a constitutional amendment instead of a new law, Missouri supporters have ensured that lawmakers will be unable to change it without going back to voters.

Opponents, including Missouri Gov. Mike Parson, said a Medicaid expansion could mean cuts elsewhere, citing the potential costs as reason to oppose the ballot initiative.

“Less money for kids, less money for police, less money for roads and bridges and less money for those who are most in need,” State Rep. Cody Smith, who chairs the House Budget Committee, previously said.

Auditor Nicole Galloway’s office estimated that expanding Medicaid could cost the state at least $200 million or save as much as $1 billion annually by 2026. 

But supporters believe health care is a right, not a “handout.”

The AARP, Missouri Hospital Association and the Missouri Chamber of Commerce support Amendment 2.

The chamber, citing economic projections wrote “expanding Missouri’s Medicaid program will boost job creation by 16,000 jobs per year for five years. Likewise, passage will expand our state’s economic output by $2.5 billion.”

Thirty-seven states, including Oklahoma just last month, have already expanded Medicaid.