Missouri Supreme Court deems Medicaid expansion constitutional, reversing lower court

The Missouri Supreme Court unanimously struck down a lower court’s ruling on Medicaid expansion, issuing an opinion Thursday stating that a voter-approved plan to increase access to the health care program does not violate the state constitution and should be enacted.

The decision means an additional 275,000 Missourians are eligible for the program.

Under a constitutional amendment approved by Missouri voters last August, eligibility was expanded to include individuals earning up to 138% of the federal poverty level, or about $18,000 a year.

The court’s opinion states that the expansion measure “does not appropriate money and does not remove the General Assembly’s discretion in appropriating money” to Missouri’s Medicaid program. Therefore, the court ruled, expansion is allowable under the state constitution.

However, the court found that because state lawmakers were not denied the freedom to designate the amount of funding allocated for Medicaid, it is in their power to decide how much funding is appropriate for the program.

If the funding is not sufficient to meet the needs of Medicaid, the General Assembly may need to allocate more funds in order to keep from bankrupting the program.

The case will now be sent back to Cole County Circuit Judge Jon Beetem. He ruled in June that the Medicaid expansion measure was unconstitutional, resulting in the case being appealed to the Supreme Court. Beetem will decide if people will be able to enroll in Medicaid despite the fact that the expected expense of $1.9 billion was not funded in the state budget.

Any motion for a rehearing in the case must be entered within five days of Thursday’s ruling.

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