Missouri’s Aug. 4 primary has snuck up fast during a year when the U.S. presidential election is looming large amid a global pandemic. But plenty of key local races will be decided in the heavily Democratic St. Louis region — and voters throughout the state will determine whether Missouri expands Medicaid coverage, joining the 37 other states that have opted to do so in conjunction with the Affordable Care Act. If passed, Amendment 2 (the Medicaid Expansion Initiative) would effectively expand Medicaid eligibility to include adults between the ages of 19 and 65 whose income is at or below 138 percent of the federal poverty level. As of 2020, that amounts to $17,608 for an individual and $36,156 for a household of four.