Daily Yonder graphic. See county definitions below.

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Two thirds of Missouri’s rural voters opposed a state constitutional amendment to expand Medicaid in Tuesday’s election.

Statewide, the measure passed by 6.6 percentage points, 623,000 votes to 591,000.

The state’s most urban and most rural voters were on opposite sides of the ballot referendum. Nearly three quarters of voters in the core counties of the state’s major metropolitan areas (Kansas City and St. Louis) supported the measure. Only a third of nonmetropolitan, or rural, voters did.

Support for the measure faded as counties became less urbanized and more rural.

Nonmetropolitan voters constituted about a quarter of the electorate on Tuesday. Major metropolitan areas were 56% of the electorate.

Rural opponents of the measure would have needed a 60-point margin (80% to 20%) to have defeated the referendum.

The Daily Yonder’s analysis uses the following county definitions:

  • Major Metro Core – the central counties of metropolitan areas of 1 million or more residents.
  • Major Metro Suburb – the outlying counties of major metropolitan areas.
  • Medium Metro – all counties in a metropolitan of 250,000 to 999,999 residents.
  • Small Metro – all counties in a metropolitan area of 50,000 to 249,999.
  • Nonmetro – all counties that are no included in a metropolitan statistical area. In this story, nonmetro counties equate with rural.

Full-page version of the map.