Progressive challenger Cori Bush defeats 10-term incumbent Lacy Clay and voters approve Medicaid expansion in Missouri

• In a major upset, the activist, nurse, and pastor Cori Bush won her second pursuit of the Democratic nomination for Missouri's 1st Congressional District against the 10-term incumbent Rep. William Lacy Clay.
• Bush is part of a wave of progressive candidates seeking to unseat longtime Democrats. Her victory makes Clay the seventh incumbent House member to lose renomination this cycle.
• Missouri voters also passed Amendment 2, a measure to expand Medicaid eligibility to roughly 230,000 more low-income Missourians.

Editor's note: A previous version of this article stated that Decision Desk HQ projected Rep. Lacy Clay had won the Democratic primary in Missouri's 1st District. Decision Desk HQ later retracted its call and called the race for Bush.

Missouri voters on Tuesday chose winners of several primaries to advance to the November general election, from the state legislature to the governor's seat and eight US congressional races.

Tuesday's primary was the first statewide election being held since the pandemic began, with early voting starting June 23. Candidates rapidly adjusted to the new circumstances triggered by the public-health crisis, transitioning from traditional in-person campaigning to more online outreach.

Missouri has seen an uptick in coronavirus cases over the past several weeks and has reached 52,887 confirmed cases since the pandemic started. As of Tuesday, the death toll was 1,255.

1st Congressional District

In a major upset, the activist, nurse, and pastor Cori Bush won her second attempt at the Democratic nomination for the 1st Congressional District against the 10-term incumbent Rep. William Lacy Clay.

Clay is the seventh House incumbent to lose renomination from his party this cycle, along with Democratic Reps. Dan Lipinski of Illinois and Eliot Engel of New York and the Republican Reps. Steve King of Iowa, Denver Riggleman of Virginia, Scott Tipton of Colorado, and Steve Watkins of Kansas. Watkins also lost his primary Tuesday night.

Bush is part of a wave of progressive candidates cropping up around the US seeking to unseat longtime Democrats. She previously ran for the same seat in the 2018 midterm elections but failed, with 37% of the vote. Her candidacy was featured in the 2019 Netflix documentary "Knock Down the House," along with the unsuccessful campaigns of two fellow progressives and the victorious election of Alexandria Ocasio-Cortez in New York.

Bush was endorsed by Justice Democrats, a group that boosts diverse candidates who back progressive policies. The former presidential candidate Sen. Bernie Sanders of Vermont also supported the primary challenger, and more recently the progressive Jamaal Bowman threw his name behind Bush after he won his primary against Engel in New York.

A Black single mom from St. Louis, Bush became an activist after participating in the 2014 Ferguson protests provoked by the fatal police shooting of an unarmed 18-year-old Black man, Michael Brown. She is hoping to increase her political viability by building on the momentum of anti-racism and police-brutality protests following the killing of George Floyd in Minneapolis.

But her win marks the first time the seat will not be represented by a Clay in more than five decades.

Before Clay took office in 2001, his father had represented the district since 1969. Clay raised more than $740,000 for his reelection campaign, ahead of Bush's estimated $562,309 in fundraising, according to the Center for Responsive Politics.

Amendment 2

Missouri voters also passed Amendment 2, a measure to expand Medicaid eligibility to roughly 230,000 more low-income Missourians.

The Republican-controlled state has some of the strictest eligibility requirements for the health-insurance program in the nation. Leaders have staunchly opposed its expansion under the Affordable Care Act, citing affordability issues, according to NPR. One study suggested expansion would actually save the state money.

The vote came as the coronavirus crisis has left many people without health insurance after losing their employment-based coverage. The state's labor department data shows that more than 740,000 people have filed for unemployment from mid-March to the end of July.

Missouri now joins 38 other states that have expanded Medicaid, and is the second state along with Oklahoma to expand Medicaid with a ballot initiative in 2020. Coverage for the newly eligible will begin in 2021.