Medicaid expansion prevailed in Missouri last week (53.2% to 46.7%) thanks to overwhelming support in urban areas and critical backing from suburban voters who have consistently elected Republicans.
Less obvious but just as important were rural Missourians. Usually written off as reflexively hostile to government initiatives, 1 in 3 rural voters (102,000) turned out for expansion. Without them, the proposed constitutional amendment would have failed by more than 20,000 votes.
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