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Three people file lawsuits against Missouri over lack of Medicaid expansion

Cole County courthouse in Jefferson City
Cole County courthouse in Jefferson City


Three people have sued the state for not expanding Medicaid eligibility after voters approved a constitutional amendment in August.

The plaintiffs from Fenton, St. Louis and Springfield filed a lawsuit Thursday that seeks to force state leaders to expand the program to cover low-income working adults. The lawsuit names the Missouri Department of Social Services, which runs the state's Medicaid program, MO HealthNet, along with several social services officials.

Gov. Mike Parson's budget included funding for Medicaid expansion. However, the Republican-controlled state legislature decided against funding the expansion. Last week Parson said the state was withdrawing its plans to expand eligibility, saying the amendment that expanded Medicaid is invalid because it didn't include a funding mechanism and the General Assembly didn't appropriate money to pay for expansion.

"This position has no merit," the lawyer for the plaintiffs, Chuck Hatfield, writes in the petition filed in Cole County. Nothing in the Department of Social Services' budget keeps the state from using appropriated money to cover newly eligible Missourians, Hatfield wrote.

According to the lawsuit, the plaintiffs are among the more than 275,000 Missourians who would be eligible under expansion. The lawsuit asks the court to force the state to enroll the newly eligible under the constitutional amendment.

A Department of Social Services spokeswoman said the department does not comment on pending litigation.

MO HealthNet has one of the nation's strictest eligibility rules. It does not cover most non-disabled adults without children. Parents are able to qualify if their household income is below 21% of the federal poverty line, which in 2021 is less than $5,000 a year for a family of three.

The expansion would have raised the eligibility to 138% of the federal poverty line or just below $18,000 a year.

The expanded eligibility would have taken effect July 1.

Lowell Pearson, a Public Policy Attorney, who was one of the attorneys who filed the lawsuit, says the funds are there for the Medicaid Expansion. It is a constitutional right of those who would become eligible.

"If this newly eligible population ends up increasing the cost enough that the money that’s been appropriated is insufficient, then this legislature ought to appropriate the money when the problem occurs but to just say upfront that these people have no right to coverage, no right to the health care that the constitution says they get, to me is vastly premature, so the point of the lawsuit is really to get these people the coverage that they are entitled to that they need starting on July 1st," said Pearson.

Pearson says they expect to move the lawsuit quickly because of its tight deadline, to get those eligible Medicaid coverage by July 1st. He expects the case to make it to court by next month.

"Our intention is to move the case very quickly and to obtain a court order that will allow these people to get their coverage on July 1st. Often times we hear about lawsuits that drag on years and years, this is not one of those lawsuits," said Pearson.

As voters made the Medicaid Expansion as part of the constitution, Pearson says it's unconstitutional for the expansion not to take place. His goal along with his partners on the lawsuit is to ensure those in need get the health care coverage they are entitled to according to the constitution.

"I always go back to the court here and that is that the voters created a constitutional right to coverage and these people need help and these people need health care starting July 1st and I don’t really much care if people disagree with that, with the lawsuit. It’s something that has to be done for the constitution to apply," said Pearson.

Republican state Rep. Chuck Basye, R-Rocheport, told ABC 17 weeks ago, that he was worried that expanding Medicaid will take away from other important departments such as education and public safety.

State Rep. David Tyson Smith, D-Columbia, said this matter should have never been taken to court.

"Unfortunately it’s had to come to this but I’m glad that the suit has been filed because the legislature should have funded it, Medicaid expansion. Hopefully, the court will do the right thing and sight with the plaintiffs and ruled that the lack of funding is unconstitutional," said Smith.

Some health officials are concerned with the access of health care for those in need. Emily Kalmer with the American Cancer Society Cancer Action Network said over 275,000 Missourians fall into the gap and need health insurance coverage.

"These three plaintiffs are just a few of the hundreds of thousands in Missouri who could access healthcare through Medicaid expansion. We were happy to see their efforts to move forward with it. Each day of delay with Medicaid expansion means a later diagnosis, later treatment," said Kalmer.

She says they'll continue to follow the lawsuit and urge lawmakers to move forward with Medicaid expansion as the people have already voted for it.

"We’ll be following the lawsuit closely, we’ll also continue to urge lawmakers and the governor to move forward and implement the voter’s will. The folks in Missouri can’t wait for a legal these legal battles to make their way through the courts we need to move forward with the voter’s will today," said Kalmer.

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Matthew Sanders

Matthew Sanders is the digital content director at ABC 17 News.


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