On August 4, Missouri has the chance to join the 37 other states who have expanded Medicaid, granting health care access to more than 230,000 low-income Missourians. After a decade, evidence of the benefits of expansion is clear. While no single policy can put an end to the devastating racial health care disparities we see across the country, the evidence is overwhelming that Medicaid expansion significantly reduces them.

The differences between expansion and non-expansion states is stark and can quite literally mean life and death, starting from the earliest moments of a person’s life. In Missouri, the Black infant mortality rate is more than double the rate for white infants, premature births happen at a significantly higher rate for Black mothers, and Black mothers are also more than twice as likely to lack prenatal care as compared with white mothers. In states where Medicaid is expanded, the impacts are critical for mothers and their children: both infant and maternal mortality rates decrease, children are more likely to have access to preventive pediatric care and are more likely to be insured, mothers are more likely to have access to postpartum care, and racial health care disparities for infants are reduced.

These life and death health care disparities start at birth and often continue throughout an individual’s life. In Missouri, in all chronic diseases studied, including heart disease, diabetes, cancer, stroke, and essential hypertension, Black Missourians die at horrifyingly higher rates than white Missourians, and in some cases by more than double or triple the rates of white Missourians. Again, there is more than ample evidence to show that Medicaid expansion directly impacts treatment and health outcomes for these diseases, resulting in reduced death rates from cancer, increased access to diabetes medication, and reduced diabetes-related amputations.

Not to mention the myriad of ways in which health care disparities, particularly the steep cost of medical care for the uninsured and those that delay care due to cost, spill over and contribute to financial disparities experienced by Black Americans. In Missouri, people of color make up 29% of the uninsured rate and 28% of those newly eligible for Medicaid with expansion, while meanwhile only representing 17% of the state’s population. When Medicaid expansion is implemented, this means fewer people deciding between paying for medical care and keeping their homes. Families with access to such coverage are 25% less likely to miss a rent or mortgage payment, leading to reduced evictions, foreclosure, and homelessness. Medicaid expansion also correlates with reduced payday borrowing and loan debt.

Not only does Medicaid expansion directly lead to improved health outcomes for Black and brown Americans, but it also has far-reaching impacts on an individual’s financial stability overall. Missourians have the chance to make a huge difference in the lives of hundreds of thousands of people in their state by expanding Medicaid on August 4.