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Judge Orders Missouri To Implement Medicaid Expansion

Supporters of Medicaid expansion in Missouri rally at the state capitol on April 27, 2021.
Sebastián Martínez Valdivia
Supporters of Medicaid expansion in Missouri rally at the state capitol on April 27, 2021.

The state of Missouri cannot deny the applications of people who qualify for Medicaid under expanded eligibility. That was the decision handed down by Cole County Circuit Judge Jon Beetem on Tuesday.

Beetem's order also stops the state from imposing, "additional burdens or restrictions on eligibility or enrollment standards," on the expansion population.

Attorneys for the state asked Beetem for more time last week, saying the Department of Social Services needed another two months to prepare for implementation. But Beetem's order takes effect immediately.

Nevertheless, Chuck Hatfield, who represented the women who sued for coverage, expects the state to act in good faith.

"I'm honestly optimistic that this is it, and that they'll go ahead and implement," Hatfield said. "We don't want to be back in court on this."

As of Tuesday afternoon, the page on the state's website dedicated to MO Healthnet — Missouri's Medicaid program — did not list the new criteria for eligibility.

Under expansion, those making 138% of the Federal Poverty Level or less, around $17,770 for an individual, can qualify for Medicaid coverage. The Department of Social Services did not respond to a request for comment.

The order was a win for Medicaid expansion proponents, and the conclusion of a court case that began in June, when three women sued the state for coverage.

Their lawsuit came shortly after Gov. Mike Parson announced his administration would not carry out voter-approved Medicaid expansion. Parson said the state couldn't expand Medicaid because the legislature hadn't appropriated the funds he requested to pay for it.

Beetem initially sided with the state in June, finding the initial ballot measure voters approved in August of 2020 was unconstitutional. On appeal, though, the Missouri Supreme Court unanimously overturned that ruling, stating that not only was the measure constitutional, but also nothing prevented the state from using funds appropriated by the legislature to pay for expansion coverage.
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Sebastián Martínez Valdivia is a health reporter and documentary filmmaker who focuses on access to care in rural and immigrant communities. A native Spanish speaker and lifelong Missouri resident, Sebastián is interested in the often overlooked and under-covered world of immigrant life in the rural midwest. He has a bachelor's degree in broadcast journalism from the University of Missouri and a master's degree in documentary journalism at the same institution. Aside from public health, his other interests include conservation, climate change and ecology.