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Medicaid expansion suit filed in Cole County

JEFFERSON CITY, Mo. — The first lawsuit over the state’s lack of funding for Medicaid expansion was filed in Cole County Thursday, setting the stage for a legal battle over the controversial measure.

The suit against the Department of Social Services (DSS), Acting Director Jennifer Tidball, the MO HealthNet Division, and the Family Support Division, among others, was filed in the Cole County Circuit Court Thursday.

The challenge was leveled by three plaintiffs from across Missouri who would be eligible under the expansion, arguing the department had the ability to fund the program under statute. Their legal team is made up of unlikely allies: Lowell Pearson, former general counsel to GOP Gov. Matt Blunt, joins Chuck Hatfield who served as chief of staff for Democratic Attorney General Jay Nixon during his tenure. 

“The DSS appropriations bill does not limit any MO HealthNet funding for coverage of particular categories of eligible individuals,” the lawsuit said. “Nothing in the DSS appropriations bill prevents the agencies from using appropriated funds to cover individuals whose eligibility arises under the Constitution. In other words, DSS, the MO HealthNet Division, and the Family Support Division have full authority to implement Medicaid Expansion as directed by the Missouri Constitution.”

The lawsuit asked the court to find the lack of funding for the expansion unlawful and sought an injunction to allow the plaintiffs and others who would be eligible to enroll and receive the same treatment as those already covered under the program. 

The plaintiffs — Autumn Stultz, Melinda Hille, and Stephanie Doyle — suffer from a myriad of health conditions, including chronic asthma, Type 1 diabetes, and severe eczema. They would all be covered under the expanded program. 

Despite being approved by Missouri voters and being included in Gov. Mike Parson’s initial recommended budget, funding for the program’s expansion failed to pass alongside the state’s $34 billion budget this session. Critics in and outside of the legislature have pointed to the lack of a clear funding source in the ballot measure’s language, an issue that failed to hold the petition back from the ballot despite legal challenges. The same argument was used by members in the upper chamber who opposed the appropriation. 

The suit quickly drew support from advocates, including the Missouri Budget Project and the American Cancer Society Cancer Action Network of Missouri. 

“On July 1, under Missouri’s constitution, that eligibility will be expanded to childless adults with incomes up to 138 percent of the federal poverty level — which means that doctors’ visits, medications, and other services can and should be provided through MO HealthNet at that time,” said Missouri Budget Project President and CEO Amy Blouin. “We are confident that the courts will uphold the people’s vote in support of Medicaid expansion. After years of delay, we look forward to our state being able to finally experience the many health, economic, and budget benefits of expansion.”

“Access to health insurance is key in the fight against cancer,” American Cancer Society Cancer Action Network Missouri Government Relations Director Emily Kalmer said. “These plaintiffs are just three of the hundreds of thousands of Missourians who need the state to move forward with the coverage voters approved. Each day of delay means a later diagnosis, later treatment, and greater likelihood that Missourians will die of cancer.”

Missourians voted to become the 38th state to expand its Medicaid program last August, moving to cover more than 200,000 people who earn less than $18,000 a year. The change has an effective date of July 1.

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