Fight over Missouri Medicaid expansion heading to the courts


Jefferson City — The fight over Medicaid expansion in Missouri has moved from the state Capitol to the courts.

A lawsuit filed May 20 in Cole County Circuit Court seeks to require the state to expand its Medicaid program in accordance with the constitutional amendment 53 percent of voters supported last August.

Lawmakers left Jefferson City May 14 without funding the program, which would provide health care services to 275,000 low-income adults earning up to 138 percent of the federal poverty limit.

Opponents of the expansion in the Republican-dominated Legislature argued proponents should have included a funding mechanism in their ballot language.

The GOP-controlled House and Senate didn’t include the funding, though Gov. Mike Parson’s proposed budget in January set aside $120 million for the expansion, but the GOP-controlled House and Senate didn’t include the funding in the final budget.

Because of that, Parson’s administration has opted not move forward with the expansion, clearly violating the state’s constitution.

“The people voted for Medicaid expansion,” said State Senator Doug Beck (D-Affton), a member of Plumbers and Pipefitters Local 562. “Medicaid expansion is in our constitution. There is more than enough money in the existing budget to begin expansion as the constitution requires on July 1; the state is sitting on a record surplus. “This issue is entirely in the hands of the courts now, which is unfortunate, and expensive,” Beck said.

“The people have finally weighed in on this. And now the Legislature is going to abdicate its duties and leave its responsibility to a judge?” Senate Minority Leader John Rizzo said. “I don’t know what shark we have jumped here. God forbid the people have a voice.”

Amy Blouin, president and CEO of the Missouri Budget Project, a nonprofit public policy analysis organization that analyzes state budget, tax, and economic issues, said in a statement the group was confident the courts will uphold the expansion.

“We are confident that the courts will uphold the people’s vote in support of Medicaid expansion,” Blouin said. “After years of delay, we look forward to our state being able to finally experience the many health, economic, and budget benefits of expansion.”

The lawsuit was filed against the Department of Social Services of behalf of three Missourians who would become eligible for services on July 1 under the constitutional amendment.

It follows comments by Michael Neidorff, the CEO of Clayton-based Centene, one of the region’s largest companies, who threatened recently to leave Missouri over the state’s lack of Medicaid expansion.

Neidorff raised similar concerns last year when he said his efforts at recruiting top-notch talent to the region were being hurt by crime and the image it gives St. Louis, as well as the state’s ongoing reluctance to expand Medicaid.

“As the largest provider of Medicaid in the United States and a Fortune 42 company I have to ask myself, ‘Why am I in this state?’” Neidorff told Health Payer Specialist, a health industry trade publication. “This is a state that frowns on this business — what am I doing here? It’s an embarrassment.”



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