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Missouri Supreme Court reverses Medicaid expansion decision

Case Overview

After voters passed the amendment in 2020, Governor Mike Parson refused to implement it after the GOP-led Legislature didn’t provide any funding. Three women, who were newly eligible for Medicaid, filed a lawsuit.

A month ago, a Cole County judge ruled, overturning the constitutional amendment passed by voters.

The case then went to the Missouri Supreme Court, which started hearing the case nine days ago. The plaintiffs’ attorney, Chuck Hatfield, told the Supreme Court that the actions by the state would essentially “overturn the election.”

But Solicitor General John Sauer had urged for the Supreme Court to let the Circuit Court’s ruling stand. He wanted to “preserve the Legislature’s traditional authority” over the budget.

Advocates for the expansion expressed relief over the ruling.

“We look forward to seeing Medicaid expansion swiftly implemented by the State so that all eligible Missourians receive the access to healthcare they need,” read a statement from the group Healthcare for Missouri. “This is not a partisan issue or a political issue – it’s a people issue.”

Missouri’s Medicaid program currently does not cover most adults without children. Its income eligibility threshold for parents is one of the lowest in the nation, at about one-fifth of the poverty level. The expansion is expected to add Medicaid eligibility for up to 275,000 low-income Missourians.

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

The case now goes back to Cole County Circuit Court.

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