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Missouri must open Medicaid eligibility to expansion population

JEFFERSON CITY, Mo. — Missouri must open its Medicaid eligibility to the expansion population, a judge ruled Tuesday morning.

Cole County Judge Jon Beetem said the Department of Social Services (DSS) cannot deny individuals who qualify under the expansion from enrolling in the MO HealthNet program. Additionally, those people cannot be subject to any additional restrictions or burdens than those already placed on Medicaid recipients. 

The expansion opens up Missouri’s Medicaid program to about 275,000 individuals in the state. It covers those making less than $18,000 per year and initially had an effective date of July 1. 

“The latest Republican attempt to block and delay Medicaid expansion has failed,” Senate Minority Leader John Rizzo said on social media. “Let’s be clear: Health care for working families is a good thing.” 

The state had asked for a two-month delay to ensure it had the adequate technology to handle the influx of recipients, but no such stay was included in Beetem’s two-page order. The Attorney General’s Office declined to comment. 

Late last month, the Supreme Court of Missouri unanimously remanded a lower court’s decision, saying the constitutional amendment expanding Medicaid did not appropriate money or hamper the legislature’s discretion in appropriating funds. 

“I’m gonna follow the law. I’ve always done that, and I’m going to continue to do that,” Gov. Mike Parson told reporters Tuesday morning. “We don’t have the funding to support it right now so we’ve got to figure out how we’re going to do that — whether we’re going to dilute the pool of money that we have now for the people that are on the program or how we’re going to move forward.”

Lawmakers in both chambers and on both sides of the aisle have speculated there’s enough money already appropriated for the Medicaid program until at least January when lawmakers will already be back in the Capitol and can pass a supplemental budget.

Rep. Rasheen Aldridge sent a letter to the governor asking for a special session to ensure enough money is appropriated to fully fund Medicaid to include the expanded population, however.

“[T]he people of this state cannot afford to wait a second longer for the realization of expansion after having their decision deferred by a government that occasionally seemed hellbent on undermining their choice,” Aldridge said. “We still have work to do on that front, given the majority’s limited funding for Medicaid in our state with the passage of the FY 2022 budget.”

“We have already put expansion off for too long, even before the drama of the last year. Medicaid expansion would have helped our state during the COVID-19 pandemic, especially benefitting people of color and Missourians who live in high poverty communities by providing greater access to much needed medical care.”

Beetem had previously deemed the 2019 Amendment 2 unconstitutional due to its lack of a funding source. The lawsuit brought against DSS, Acting Director Jennifer Tidball, and the MO HealthNet Division, among others, was filed in May on behalf of three single mothers who would be covered under the expansion. 

The order for Missouri to allow eligible Missourians to apply for Medicaid came on Missouri’s bicentennial.

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Cameron Gerber contributed to this report.

This story has been updated.