Missouri Supreme Court overturns Medicaid extension decision



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ST. LOUIS (AP) – The Missouri Supreme Court on Thursday dismissed a challenge to the state’s voters approved Medicaid expansion plan, overturning a lower court ruling that the constitutional amendment would wrongly force lawmakers to set aside additional funds.

The unanimous decision returns the case to Cole County Circuit Court, where Judge Jon Beetem last month declared the amendment unconstitutional. The Supreme Court justices wrote that the plan does not limit the budgeting powers of the legislature.

“An initiative that simply costs money to implement does not necessarily require the allocation of funds,” the judges wrote, “as long as the General Assembly retains its discretion to allocate funds to implement this initiative “.

Three women newly eligible for Medicaid sued after Republican Gov. Mike Parson refused to implement it on July 1 because the GOP-led legislature did not set aside additional money for it in the state budget.

Supreme Court justices have not issued an order forcing Parson to begin providing services to new Medicaid recipients. They left the lower court judge “to render judgment for the plaintiffs, which includes determining the appropriate injunction.”

A spokesperson for the Missouri attorney general’s office, which has defended Parson’s actions in court, declined to comment, citing an ongoing litigation.

The judges wrote that even though there is no additional funding in the budget specifically to pay newly eligible residents, the state is still obligated to provide them with health care, as called for in the new constitutional amendment. That could force state lawmakers to return mid-year to set aside more money for the program.

One of the plaintiffs’ attorneys, Chuck Hatfield, said Thursday that the unanimous decision “sends an important message” that the state will ultimately have to cover the full cost of the expansion.

“We have a great group of people who are just above the poverty line,” Hatfield said. “These are the working poor. They need health services.

He also noted that the decision would mean that since the federal government pays the bulk of the cost of Medicaid, Missouri will see a large infusion of funds “to pay the nurses, doctors and pharmacists who provide the service.”

Critics of the Medicaid expansion, primarily Republicans, have said it could end up costing the state money and therefore reduce funding for other government services.

“Missouri taxpayers now face potential education cuts or tax increases to cover these new costs,” Americans for Prosperity-Missouri state director Jeremy Cady said Thursday.

Supporters of the expansion said they were relieved by the decision.

“We look forward to seeing the rapid state-implemented Medicaid expansion so that all eligible Missourians have access to the health care they need,” read a statement from the Healthcare for Missouri group. “It’s not a partisan issue or a political issue – it’s a people issue.”

Prior to Medicaid’s expansion, Missouri’s health care program did not cover most adults without children, and its income threshold for parents was one of the lowest in the country, at about a fifth of the level of. poverty. The expansion is expected to add Medicaid eligibility for up to 275,000 low-income Missourians.

Voters approved the Medicaid expansion last August, passing a constitutional amendment by 53% of the vote.

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Ballentine contributed to this report from Columbia, Missouri.

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