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Medicaid expansion ballot measure allowed to continue after appeals court ruling


The Medicaid expansion initiative is set to remain on the August ballot after the Missouri Western District Court of Appeals affirmed a lower court’s earlier decision.

In a unanimous opinion Monday, the appellate triumvirate affirmed the Cole County Circuit Court’s decision, finding judicial review was inappropriate before voters have a chance to approve or reject the ballot measure, known as Amendment 2. It further approved the lower court’s finding that the initiative neither appropriated funds on its face nor amended state law. 

United for Missouri and Americans for Prosperity-Missouri (AFP-MO) filed separate lawsuits in May challenging the constitutionality of the initiative petition. Both organizations expressed concern over the revenue needed for the initiative, arguing the measure didn’t properly cite a funding source by pointing to Articles III and IV of the Missouri Constitution. 

The suits initially failed last week as a Cole County judge found the petition did not violate Missouri law. The ruling said that the initiative did not change how the General Assembly appropriates funds nor does it, on its face, appropriate funds. 

Both organizations immediately filed appeals, and the court agreed to expedite the process. The appeals were leveled by Americans for Prosperity Missouri state director Jeremy Cady and United for Missouri’s Ryan Johnson. 

The appeals, leveled by AFP-MO state director Jeremy Cady and United for Missouri’s Ryan Johnson, challenged the decision on three grounds: by asserting the petition does indeed violate Article III, that it does not do so on its face, and the initiative specifically violates Section 50 of Amendment III, which requires a petition to contain the full text of the measure (the challengers asserted it does not).

“Today’s ruling on Amendment 2 ensures Missourians get to vote August 4 to deliver health care to hardworking families, help keep rural hospitals open and protect frontline healthcare jobs,” Yes on 2 Campaign Manager A.J. Bockelman said in a statement. “Never has a vote been so important to our health and our economy. It’s time to bring more than a billion of our tax dollars home from Washington every year — money that’s right now going to places like New York and California instead of our local communities.”

The measure was moved from the November ballot to August by Gov. Mike Parson last month. Parson has voiced his own concerns about the issue but said he change in ballot date was a matter of economics rather than politics. 

The ballot language asks voters to amend the Missouri Constitution to expand MO HealthNet services for individuals between 19 and 64 years old with an income level at or below 133 percent of the federal poverty level. It would also prohibit additional burden on eligibility for enrollment standards if approved. The income benchmark would be less than $18,000 for an individual or $30,000 for a family of three.

Thirty-six states have already adopted Medicaid expansion measures. The State Auditor’s Office has estimated expanding Medicaid eligibility would save the state around $1 billion. 

“We respectfully disagree with the findings of the courts, and we will continue the fight until we have exhausted our appeals,” United for Missouri CEO Carl Bearden told The Missouri Times. “The people of Missouri should not be asked to approve a measure that will have disastrous effects on other areas of the budget, such as education and other existing programs, especially when the truth is being covered up by the proponents of the measure.”  

Cady did not immediately respond to a request for comment on the appellate court’s decision.