Which Missouri health care and business groups are supporting Medicaid expansion?

Galen Bacharier
Springfield News-Leader
Demonstrators stand outside of the Governor’s Mansion in Jefferson City on July 1, urging Gov. Mike Parson to fund Medicaid expansion. In the weeks leading up to the issue's high court hearing, groups from around the state have submitted briefs supporting expansion.

This story was updated at 2 p.m. on Monday, July 12 to include information about Missouri House Democrats filing a brief with the Missouri Supreme Court.

As the Missouri Supreme Court prepares to hear arguments on the future of Medicaid in the state next week, groups are declaring their support for or opposition to its expansion.

Health organizations, providers and business groups from around the state, as well as the House of Representatives, have submitted amicus briefs, or documents expressing their interest and support in the case. The high court will hear arguments on July 13.

Three women suing the state are appealing a lower court ruling in June that the voter-approved Medicaid expansion amendment was unconstitutional. The decision will determine whether roughly 275,000 additional Missourians qualify for the state's low-income health care program. Cole County Circuit Judge Jon Beetem's June 23 ruling meant those residents were not enrolled starting on July 1, as outlined under the amendment. 

The Missouri House of Representatives filed a brief Thursday declaring its support for the state in the case, arguing that the chamber "has interest in the appeal to protect its constitutional role in the appropriation process," and that Amendment 2 should be upheld as unconstitutional.

Funding for Medicaid expansion was excluded by the Republican supermajority in the final budget sent to Gov. Mike Parson this past legislative session, despite expansion being approved by voters last year. Americans for Prosperity, a conservative political action group, also filed a brief Thursday backing the state.

Background:Missouri Supreme Court will decide whether to expand Medicaid benefits

House Minority Leader Crystal Quade, a Springfield Democrat, called out House Republican leadership in a statement last week, calling the brief a false representation of the chamber's position on the issue since the full House had not voted to involve itself in the case.

"Republican leadership's blatant attempt to misrepresent the House's position before Missouri's highest court demonstrates contempt for a co-equal branch of our government and should be met with whatever sanctions the court deems appropriate," Quade said.

House Democrats filed a brief in response to the House's on Monday, asking the court to disregard Republican leaders' submission or not attribute its contents to the chamber at large.

"The Missouri House never authorized the filing of this amicus brief on its behalf, nor the hiring of outside counsel to assist in such an effort," states the brief, which was submitted by attorney Casey Millburg. "The rules and other authorities governing the Missouri House's operations are clear: the only way this brief could be valid is if the Missouri House's members voted to pass a (resolution) authorizing outside counsel to file it. No such vote has occurred."

Health care and business groups

A group of 33 health care providers, national organizations and researchers submitted a brief on June 30 — with each of the organizations citing Medicaid as a vital part of their patient bases and functions. It cites studies that say expansion would lead to better access and care, improvements on the state budget and economy and a stronger safety net in Missouri.

"The research findings are highly consistent: Medicaid expansion has increased health care coverage and improved access to and use of necessary services," says the brief, submitted by attorney John J. Ammann.

Joining those groups are 12 health clinics from around Missouri that submitted a brief to the court on July 2. The clinics serve over 600,000 patients a year, according to their filing — many of them at or below the poverty line. 

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"As many as 150,000 of the centers' patients could be directly affected by what the Court decides in this case," says the brief, submitted by attorney James Layton on behalf of the centers. "But so will the centers themselves."

Medicaid expansion, the clinics argue, will allow federal dollars to flow to Missouri and thus permit them to expand their coverage and services.

Proponents of expansion also have frequently said that it would be a boon for the state's economy. In a brief submitted to the court on June 30, business groups from around the state — including the Springfield Area Chamber of Commerce — agree.

"The expansion of Medicaid to low-income adults in other states has produced economic and health benefits, and the Springfield Chamber supports the effort to provide better coverage and increased access to more affordable care to Missourians," the chamber's statement reads.

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The Foundation for Government Accountability, a national nonprofit, submitted a brief on Wednesday against expansion, stating that the case "directly implicates FGA's core mission of helping individuals live healthy, independent and fulfilling lives."

The Missouri Supreme Court will hear arguments for the Medicaid expansion case at 11 a.m. on Tuesday, July 13.

Correction: A previous version of this article mischaracterized the position of the Foundation for Government Accountability's amicus brief. The FGA's brief is in opposition to Medicaid expansion.

Galen Bacharier covers Missouri politics & government for the News-Leader. Contact him at gbacharier@gannett.com, (573) 219-7440 or on Twitter @galenbacharier.