The ACA, passed in 2010, calledfor extending Medicaid to all Americans earning up to138 percent of the federal poverty level, around$17,000 annually for an individual. 

ST. LOUIS — Patricia Powers went a few years without healthinsurance and couldn't afford regular doctor visits. So she had noidea cancerous tumors were silently growing in both of herbreasts.

If Powers lived just across the Mississippi River in Illinois,she would have qualified for Medicaid, the federal-state healthinsurance program for low-income residents that 36 states and theDistrict of Columbia decided to expand under the Affordable CareAct. But Missouri politicians chose not to expand it — a decisionsome groups are trying to reverse by getting signatures to put theoption on the 2020 ballot.

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