Decision expected later this week on Medicaid expansion lawsuit

JEFFERSON CITY, Mo. (KMIZ)

A Cole County judge said he hopes to issue a ruling this week on a lawsuit that would require Missouri to offer Medicaid to an expanded population.

The lawsuit, filed last month by three people who would be eligible for coverage under expansion, seeks to force the state to enroll the newly eligible in Medicaid despite the legislature not appropriating money for expansion and the governor withdrawing plans to open up Medicaid rolls to more people.

Judge Jon Beetem heard arguments Monday afternoon after the case was filed last month in Cole County. Beetem said he hoped to make a decision in the next "day or two," saying his ruling could come out Wednesday. Each side is expected to appeal the decision if Beetem rules against them.

The state has argued that the legislature did not approve money to pay for the cost of expansion. Voters approved it with a ballot measure last year as a constitutional amendment, but the state says that under the Missouri Constitution the ballot measure required appropriations because it didn't have a funding source built in.

The lawyers who brought the lawsuit say the state has money available to pay for expansion. If the cost is greater than expected the state can appropriate more money for the program, they argue.

Chuck Hatfield, who represents the three women suing, said the state has to offer the people Medicaid if they're eligible, regardless of the legislature's intent not to provide money for an increase in people using the program.

"There is money to pay for Medicaid services," Hatfield said. "Once that's done, those folks who are eligible under the Constitution are entitled to those services."

Solicitor General D. John Sauer argued that a "reasonable reader" of the state budget bills would see the legislature did not intend to cover the newly-eligible population this year to defend the department not offering coverage. He pointed to the lack of money in the Department of Social Services, Department of Health and Human Services and Office of Administration for expansion, and lawmakers rejections of amendments to add such money into it. Hatfield pushed back on that point, saying the court should only focus on what the legislature did pass to make its decision.

"I think that what the state's arguing is that a reasonable reader of the things that the state wants to look at might reach a different conclusion," Hatfield said. "We're confident the court's not going to do that. The court's going to look at the current law, the language that the legislature did adopt."

MO HealthNet, the name of the state's Medicaid program, 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.

Advocates say about 275,000 Missourian would be newly eligible if the state follows through with expansion.

The plaintiffs asked Judge Beetem to order the state begin enrolling those newly-eligible come July 1. Hatfield said he would wait and see how the courts, including the appeals court and Supreme Court of Missouri, handle that issue should the case not be resolved by then.