Last summer, 53 percent of Missouri voters supported a constitutional amendment to expand the state’s Medicaid program, part of the Affordable Care Act. That expansion was supposed to go into effect at the beginning of July 2021. But the state’s legislature refused to appropriate funds for it—even though the federal government will cover 90 percent of the costs—and the Republican governor, Mike Parson, withdrew the state’s federal application for the expansion.
But thanks to a unanimous ruling by the Missouri Supreme court on Thursday, which overturned a lower court ruling, the legislature now has to fund the expansion of the state’s Medicaid program, MO HealthNet. In a “per curiam” opinion, meaning it was not authored by a specific judge, the court wrote that the expansion was “valid and now in effect.”
The Medicaid expansion will apply to adults between 19 and 65 in households earning 138 percent of the federal poverty level or less—approximately $18,000 per year for a single adult and $36,570 for a family of four. Without the expansion, Missouri’s Medicaid eligibility requirements were more exclusionary than anywhere else in the U.S., where a family of three making more than $4,600 a year — above 21 percent of poverty level — would not qualify.
Democratic Senate Minority Leader John Rizzo told the Missouri Independent that the ruling “is about as concise of a win as you could imagine for the people of the state of Missouri.”
Currently, 38 other states including D.C. have adopted and implemented Medicaid expansion, but 11 GOP legislatures have prevented it from reaching their constituents. That has led Democrats to find ways of circumventing Republican-controlled state legislatures by putting the issue on the ballot and letting voters decide.
Advocates for the expansion cheered the court’s decision. “As a result of the Supreme Court’s ruling, Missourians across the state will finally be able to realize the health and economic benefits of Medicaid expansion,” said Amy Blouin, president and CEO of the Missouri Budget Project. “State after state has shown that in addition to providing insurance to those eligible, expansion is a fiscal and economic boon to state economies and budgets.”
And Lisa Lacasse, president of the Cancer Action Network, said it was a “victory in the fight against cancer in Missouri.” “We know individuals without health insurance are more likely to be diagnosed with cancer at later, more costly stages and are less likely to survive,” she said.
Even after the ruling, the state’s governor claimed he “lacks the necessary budget authority” to expand healthcare coverage in the state. “We are looking at what options may be available to us to seek additional budget authority and also pursuing legal clarity,” Parson’s office said in a statement.
According to the St. Louis Post-Dispatch, Parson may bring the legislature back to discuss adding money to the budget for the expansion, but many believe there is enough in the current budget to cover the new Medicaid recipients through the end of 2021.