Missouri Supreme Court to decide fate of Medicaid expansion

Missouri News

JEFFERSON CITY, Mo. — The battle over Medicaid expansion for thousands of Missourians is now in the hands of the state’s highest court after a Cole County judge ruled last month the amendment was unconstitutional

The Missouri Supreme Court will get to decide if roughly 275,000 Missourians will become eligible for Medicaid.

Expansion was supposed to go into effect July 1, but lawmakers didn’t fund it. Because of the lack of money, the governor said the state can’t move forward. It’s now up to the seven judges to decide if those making less than $18,000 a year should be eligible. 

Three single women are suing the state for not expanding Medicaid. All three suffer health conditions and expected Medicaid to help them pay for health care and prescriptions. Chuck Hatfield is one of the attorneys representing the women. 

“The restrictive language that would say that our clients are not entitled to coverage is not in the bill,” Hatfield said during oral arguments Tuesday. “The legislature must, of course, follow the priorities that the people have set out in the constitution, and that’s where this court comes in.”

Hatfield and his team filed an appeal after the Cole County judge’s ruling said the amendment was unconstitutional because it didn’t include a funding source, sending the lawsuit to the Missouri Supreme Court. 

“It’s absurd to say the people voted to expand Medicaid and to include our clients in the Medicaid program and then by virtue of some legislative maneuvering in an appropriations bill they could be excluded,” Hatfield said. 

Voters approved expansion last August by 53%. During his State of the State address in January, the governor requested lawmakers to fund it, but instead they voted not to. 

“One of the biggest, most intensive debates in the history of the General Assembly that we just went through for the last several months,” Solicitor General John Sauer who is representing the state told the panel of judges. 

While Hatfield said lawmakers funded the overall Medicaid program, meaning there is funding for expansion, Sauer said it’s clear the legislature made it clear there is no money for it. 

“If you understand Medicaid, make it very clear what the legislature intent was here,” Sauer said. “Their intent was not to fund the expansion population, but only to fund the pre-expansion population.”

Medicaid expansion was expected to cost $1.9 billion with less than $130 million coming from the state.

“That’s very poor interpretation to say that we’re going to interpret a Medicaid appropriation bill while pretending we don’t know anything about Medicaid. 

One of the mothers is Stephanie Doyle who has three children and makes $12 an hour working a full-time job. According to the lawsuit, Doyle suffers from severe eczema and needs two medications but cannot afford them without health coverage. 

But the lawsuit decision affects not only the three women, but thousands of Missourians. 

“There is briefing in this case that Medicaid expansion actually saves the state money,” Hatfield said. 

Judge W. Brent Powell questioned Sauer if the state should be able to look at Amendment 2. 

“How is it that we can now look back at an election on an amendment that is passed and decide that it was invalidly passed and if so, how long can we continue to do that?” Powell asked Sauer. “Can we go back and look at medical marijuana and decide that was passed invalidly?”

Sauer answered by saying the court should preserve Amendment 2. He then went on to say it’s easier to review the issue after the election to determine if the correct funding was appropriated. 

Hatfield said the Department of Social Services (DSS) and Gov. Mike Parson both would comply with the court’s decision, since DSS has cooperated with the lawsuit moving quicky. 

The Supreme Court did not say when it would rule but, Hatfield expect a quick decision, saying it would be within the coming weeks. 

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