Despite Republican protests, the Missouri House approved a bill that would expand Medicaid to families with incomes up to three times the federal poverty level.
A family of four could earn almost 50,000 dollars and qualify.
Representative Charlie Shields was one of many Republicans who spoke out against the bill.
"This goes against everything that we stand for. We are telling people you can abdicate responsibility to take care of your children and we're going to take it on as a state."
The bill was a priority for Governor Mel Carnahan.
He said it would cover 90,000 uninsured children in the state.
The bill now goes to the Senate for approval. In Jefferson City, I'm Liz Cafer for KMOX news.