For the first time in a decade, Missouri has a legitimate chance to pass Medicaid expansion.

On Friday, supporters of a proposed constitutional amendment turned in nearly 350,000 initiative petition signatures to place the proposal on the November statewide ballot, according to The Associated Press.

The possibility of the GOP-dominated Missouri Legislature ever approving Medicaid expansion is slim to none. Republican lawmakers have turned back every attempt by Democrats to expand Medicaid under the terms of the Affordable Care Act.

However, the possibility of the Missouri voters passing Medicaid expansion is very real. At least one early poll shows wide support for the measure.

Supporters hope that if the people have a say, Missouri will finally join the majority of states in expanding health care coverage to thousands of low-income citizens. If that happens, it could not only save lives but save taxpayers’ money while improving health outcomes for thousands of Missouri residents.

The Affordable Care Act provides a higher federal funding share to states that approve expansion of their Medicaid programs to those who earn up to 138 percent of the federal poverty level, or about $17,600 for an individual and $30,000 for a family of three.

Thirty-six states have already passed Medicaid expansion, including five that border us: Arkansas, Illinois, Iowa, Kentucky and Nebraska. Significantly, none have changed course because implementation costs were too high. That fact is telling.

The campaign to pass Medicaid expansion is going to be spirited and will likely include some of the state’s most powerful business voices because of the positive impact on the state’s economy. Statewide, medical groups, who understand first-hand how expanding Medicaid can improve access to essential medical care and help save rural hospitals, are also going to push hard for it.

Critics will argue that the state can’t afford to expand Medicaid, especially now with budgets imperiled by the coronavirus pandemic. That argument never made sense and it doesn’t now as the rolls of uninsured explode as people lose their jobs and their employer-provided health insurance.

Because we all pay already, in higher health care costs, for the uncompensated and inefficient care that the uninsured receive in hospital emergency rooms, the argument that we can’t afford to expand Medicaid never made any sense.

It still doesn’t.