Three women suing Missouri seeking Medicaid coverage argue they're covered under the state constitution
JEFFERSON CITY — The legal battle over Medicaid expansion in Missouri kicked off Monday at Cole County Circuit Court, as attorneys representing three women suing the state argued that they are entitled to coverage under last year's voter-approved initiative expanding the program.
Those seeking coverage said that the Missouri Constitution states they qualify for Medicaid services and benefits, despite the state legislature not passing funding for the expanded program. Attorneys for the state argued that budget bills passed by the legislature never indicated that they funded that expansion, and thus those suing are not eligible.
The hearing is the first step in what is likely to be a crucial legal battle. Its eventual outcome will determine whether an additional 275,000 low-income Missourians will be enrolled in the state's program and receive its services and benefits.
Under a ballot measure approved by 53 percent of voters in August 2020, people ages 19-65 earning less than $17,774 annually per individual or $37,570 for a four-person family "shall be eligible" and "receive coverage" starting July 1. That date puts a tight timeline on Circuit Judge Jon Beteem's ruling, which he said he expects to have issued by Wednesday.
Representing the state, attorney John Sauer argued to examine the budget bills passed by the Missouri General Assembly and signed by Gov. Mike Parson as a "reasonable reader." He said the bills did not include explicit references to a "post-expansion population" for Medicaid, did not clearly outline the eligibility requirements for the program and have funding that could be interpreted as adequate for "pre-expansion."
Attorney Chuck Hatfield, representing the women suing the state, pushed back on that line of reasoning in the courtroom and in comments to reporters after the hearing, arguing that the state's position requires inspection and knowledge of details outside the budget bill itself. He rejected the notion of "pre-expansion" and "post-expansion" populations under the program, pointing to both the current constitutional language and a Missouri Supreme Court decision from last year regarding state funding for Planned Parenthood.
"The state's argument today is that we should look at things other than what the legislature really did," Hatfield said.
Those suing the state have asked Beteem to enter an injunction, Hatfield said, in which case those who qualify for the expanded Medicaid program would be allowed to enroll on July 1. If Beteem rules in favor of the state, Hatfield said the case will be appealed, likely to the Court of Appeals.
Galen Bacharier covers Missouri politics and government for the News-Leader. Contact him at email@example.com, (573) 219-7440 or on Twitter @galenbacharier.