It’s the sort of unfortunate distinction for the Show-Me State — worst in the nation in some metric or another — that is becoming all too common. Whether it is teacher pay or education funding, corrections officer salaries or investments in public health, Missouri has a habit of finishing last in areas that could help its most vulnerable residents.

The latest issue is the failure of state government to provide health insurance in a timely fashion to children living in poverty. This is a basic government function. The health insurance is funded by the federal government. All Missouri has to do is sign up kids who qualify.

It is failing in that task.

In February, according to recently released statistics, Missouri finished last in the nation for delays in getting people signed up for Medicaid and the Children’s Health Insurance Program. As first reported by the Missouri Independent, the state’s failure to allow people who qualify for the programs to quickly get access has attracted the ire of the federal government, which is sending investigators here to figure out why the state’s delays are getting worse.

In February, nearly 72% of people who tried to sign up for Medicaid or get children enrolled in the health insurance program waited more than 45 days to get approved. Just as bad, and also worst in the nation: people waited nearly an hour on the call center line, and more than 60% of the people waiting abandoned the call. The numbers are rising, though they’ve been high for years.

“It’s really depressing and frustrating,” Mary Holmes told me two years ago about similar problems with Missouri’s food stamp program.

Holmes, a 57-year-old who lives in the Hyde Park neighborhood, ended up going to food pantries even though she qualified for a federal program that Missouri couldn’t get her properly signed up for. She is one of the plaintiffs in a federal lawsuit trying to force the state to perform the fundamental duties of government.

Last month, with delays in the food stamp program continuing, a federal judge ruled in favor of Holmes and her fellow plaintiffs, ordering the state to comply with federal law.

“The evidence reflects unacceptable wait times and thousands of calls that cannot be completed,” wrote U.S. District Judge Doug Harpool. “The denial of benefits to eligible households based on the inability to complete timely interviews remains unacceptably high.”

Republicans occupy all top offices in Missouri and have super-majorities in the Legislature. A fundamental problem is those leaders’ adherence to a failed philosophy about low taxes bringing economic nirvana. That hasn’t happened during Missouri’s long race to the bottom. But it has led to a failure to hire and keep employees in multiple departments, a failure to update computer programs, and a failure to serve vulnerable residents.

Gov. Mike Parson and the supposedly pro-life Legislature toss a few scraps into the budget every year to try to address some of these issues. But it’s always too little, too late, and the problems persist, with poor people unable to access the aid promised them by the government.

It shouldn’t be that hard.

None of Missouri’s border states have a problem signing up children for the federal healthcare program. Oklahoma has zero people taking 45 days to sign up; Kentucky has nearly identical statistics. Illinois has more than twice the volume of applicants as Missouri but less than a third as many people waiting 45 days or more to be approved. No state in the nation comes close to the level of Missouri’s failure.

“All of these problems create barriers to health coverage and/or receipt of (food stamp) benefits,” said Joel Ferber, the director of advocacy for Legal Services of Eastern Missouri, one of the nonprofits involved in the food stamp lawsuit. “This means that eligible individuals are unable to access medically necessary health care services or SNAP benefits on which they rely for food.”

Missouri is failing its residents, over and over again. Every time they get called on it, state officials just offer more excuses.

When poor people can’t get health care, or hungry people can’t get food, some of them die.

There’s nothing pro-life about that.