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Missouri circuit court judge says Parson can refuse to expand Medicaid, appeal is expected

Cole County Circuit Judge Jon Beetem on Wednesday ruled that Parson acted lawfully when he refused to implement the program

JEFFERSON CITY, Mo. — A Missouri judge on Wednesday ruled that a ballot measure to expand Medicaid is unconstitutional, meaning hundreds of thousands of newly eligible adults won't be able to access the health insurance program July 1 as promised.

Cole County Circuit Court Judge Jon Beetem wrote that the voter-approved amendment unconstitutionally sought to force lawmakers to set aside money for the expansion.

Under the Constitution, lawmakers can’t be forced to make appropriations unless the ballot measure includes a funding mechanism.

Beetem wrote that the amendment “indirectly requires the appropriation of revenues not created by the initiative and is therefore unconstitutional.”

Voters approved Medicaid expansion last August, passing a constitutional amendment by 53% of the vote. It was set to take effect July 1.

But Republican Gov. Mike Parson declined to provide coverage for an estimated 275,000 newly eligible low-income adults after the GOP-led Legislature refused to provide any extra funding to do so in the state budget.

Three low-income women, including two mothers, sued the state to try to force Parson's administration to give them the health insurance coverage. The plaintiff’s lawyers said they will appeal Beetem’s decision.

Beetem's ruling deals a major blow to supporters of Medicaid expansion. It all but guarantees that the thousands of newly eligible low-income adults under the amendment won't have access to the program.

Lawyers for the plaintiffs in a statement wrote that a question over the amendment's constitutionality wasn't even raised before the judge during Monday's trial.

RELATED: Single moms sue Missouri for refusing to expand Medicaid

“We are disappointed in today’s ruling, but believe the Court of Appeals will disagree,” the plaintiffs' attorneys wrote in a statement.

Attorneys defending Parson’s administration declined to comment, citing an appeal.

During the trial, Solicitor General John Sauer had argued that additional funding approved by lawmakers was needed in order for Parson to enact the amendment.

Missouri’s Medicaid program currently does not cover most adults without children, and its income eligibility threshold for parents is one of the lowest in the nation, at about one-fifth of the poverty level.

Numerous groups have weighed in following the decision in the Circuit Court.

Jason Hall, CEO of Greater St. Louis, Inc., issued the following statement after the ruling on Medicaid expansion handed down today by Cole County Circuit Court:

“Expanding Medicaid drives economic growth and job creation, creates a more equitable community, and improves the health of Missouri’s workforce. For these reasons, the St. Louis business community has been a longtime supporter of Medicaid expansion.

“The Missouri State Motto says that the welfare of the people shall be the supreme law. As such, the Court’s ruling today should not be the final word. The people have spoken, and we believe their voice should be heard at the appellate court level so that expansion of Medicaid can move forward and so that we can send a signal that Missouri is open to business and investment.”

The American Cancer Society Cancer Action Network provided the following statement:

“Today, the Cole County circuit court ruled against the plaintiffs in the lawsuit that would force the state to implement expanded eligibility for Medicaid. Cancer patients cannot wait for further legal battles to access the lifesaving coverage that Medicaid expansion provides. This year alone, 37,390 will hear the words “you have cancer” and 12,960 Missourians will pass away from cancer. None of them should suffer a day without the Medicaid healthcare coverage that a majority of Missourians voted into the Missouri Constitution. 

“ACS CAN will continue to advocate on behalf of cancer patients to ensure that they are able to access the coverage guaranteed to them by our state’s constitution.”

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