Fri. Jun 18th, 2021

JEFFERSON CITY – Governor Mike Parson halted Medicaid expansion Thursday, and now the battle for it could go to the courts.

Missouri voters approved Amendment 2 in August, which added Medicaid expansion to the state Constitution. Under the expansion, the federal government would cover 90% of the costs and the state would cover the other 10%.

However, the Missouri House and Senate voted down funding for Medicaid expansion in the 2022 budget. Gov. Parson then took the final step Thursday morning and sent a letter to the Centers for Medicare and Medicaid Services withdrawing plans to fund it.


Letter to Centers for Medicare and Medicaid Services

Medicaid expansion is set to start July 1, but University of Missouri law professor Thomas Bennett said that date could be up in the air with possible lawsuits.

“I think the one thing we can be certain of is that there will be one or more lawsuits filed, challenging the Governor’s actions and potentially the legislature’s actions as well,” Bennett said.

He also had an idea of who would bring about that lawsuit.

“It seems that given the lack of funding for the expansion and the fact that the constitutional amendment makes eligibility under the expansion mandatory. It seems likely that the lawsuit will be brought by individuals who have been made eligible under the Constitution, but who the Governor and the legislature have deemed ineligible.”

Bennett said it will be up to the courts to decide whether or not the Governor and legislature’s actions were unconstitutional.

“There’s a strong argument that they have disregarded the duty that the amendment placed on them to ensure maximum federal financial participation in the expansion. That’s one of the requirements under the Constitution – is that they expand and seek the federal government’s assistance to expand,” Bennett said.

Bennett added the court could also look at if the Governor and Department of Senior Services performed the constitutional duty to submit a plan of funding to the federal government.

“There’s also a good argument that they failed to carry out their obligation to submit a plan to the federal government, that the expansion would operate under. The Governor formally today [Thursday], in addition to the announcement that he would not be funding the plan, also sent a letter to the federal Department of Health and Human Services ending their previously sent plan,” Bennett said. 

By not providing any form of funding to Medicaid expansion, Bennett said the Governor could have increased the likelihood of a lawsuit.

“If he wanted to avoid a lawsuit, probably, allowing the expansion to go forward with a smaller amount of money that was already appropriated to DSS and Mo HealthNet would have been the safer course,” Bennett said.

Bennett said the Missouri legislature’s decision to not fund the Medicaid expansion was based on a Missouri Court of Appeals case in June.

“The argument there was under Article 3, Section 51 of the Constitution of Missouri. The ballot initiative was invalid because it sought to appropriate funds without stating explicitly that’s what it was trying to do. In other words, it was trying to spend money without telling anybody that it was spending money,” Bennett said.

However, Bennett said that argument by the Supreme Court, which the legislature based their decision on, could have been weakened by Parson’s action Thursday.

“By failing to appropriate the funds and by Governor Parson failing to move forward with the expansion, they’ve taken some of the teeth out of that argument,” Bennett said.

“Which after all depended on the idea that the initiative automatically appropriated funds in violation of a different provision of the Missouri Constitution, but the fact that the funds have not been appropriated by the legislature or the Governor just proves that the initiative did no such thing,” Bennett said.

American Cancer Society Action Network’s Government Relations Director Emily Kalmer said she is disappointed with Gov. Parson’s decision.

“Medicaid expansion helps cancer patients and those at risk for cancer get access to life saving treatment and screening,” Kalmer said.

Kalmer went on to say that early screening of cancer under Medicaid can be critical.

“We know it can save lives,’” Kalmer said.

The American Cancer Society Action Network said cancer patients can’t wait for a delay in courts and wants Gov. Parson to reverse his decision and find funding for Medicaid expansion.