Missouri’s governor says the state will proceed with voter-approved Medicaid expansion, following a recent unanimous ruling from the Missouri Supreme Court and Tuesday’s ruling from Cole County Circuit Judge Jon Edward Beetem.

Cole County Circuit Judge Jon Edward Beetem views a slide presentation from attorney Chuck Hatfield during a June 21st hearing in Jefferson City on Missouri’s Medicaid expansion lawsuit (file photo courtesy of News-Tribune” pool photographer Julie Smith)

The judge has ordered the state to enroll residents covered under the expansion. Governor Mike Parson (R) tells Missourinet that the state will follow the order.

“I think we’ll have the (governor’s office) general counsel look at that, the (Missouri) attorney general, but look: we’re going to move forward in this state. We’re going to follow the law, and the judge made an order, we’re going to respect that order. It’s been to the (Missouri) Supreme Court. It’s been through the legislative process and we got to figure out a way to move forward in this state,” Parson told Missourinet on Tuesday, during an interview at the governor’s Mansion in Jefferson City.

Judge Beetem’s ruling also prohibits the state from treating the expansion population differently.

Senate President Pro Tem Dave Schatz (R-Sullivan) tells Missourinet that there may need to be a special legislative session this fall, to discuss funding for the expansion.

“I’m not sure exactly how that appropriation, whether we would have enough money appropriated for that expansion population. I think I’ll have to be visiting with our (Senate) Appropriations chair (State Sen. Dan Hegeman, R-Cosby). Get their perspective on that. Because we did not put money in the budget for that expansion population,” Pro Tem Schatz says.

House Speaker Pro Tem John Wiemann (R-O’Fallon), is unhappy with the recent Missouri Supreme Court’s ruling, which required Judge Beetem to rule for three low-income women suing the state. Pro Tem Wiemann is reviewing Beetem’s ruling.

“We’re still working that out as far as how we want to proceed, whether we do the full implementation of basically spending the additional money it’s going to take to fund those additional enrollees, which we expect to be around 250,000, to maybe even close to 300,000 new people on Medicaid in Missouri,” Wiemann says.

Pro Tem Wiemann doesn’t believe a special session will be needed this fall, saying it can wait until the start of the 2022 session in January.

A key Democratic state senator who serves on the Senate Appropriations Committee is praising Judge Beetem’s ruling.

“Ever since Missourians voted in support of Medicaid expansion in August of 2020, there have been numerous delays in implementing the will of the voters. I am thankful the courts have finally put an end to these efforts once and for all. With this ruling, it is clear that now is time for the state to act and start allowing eligible Missourians to access the health care guaranteed to them under the Missouri Constitution,” State Sen. Karla May (D-St. Louis) says, in a written statement.

The Missouri Supreme Court issued a unanimous decision in late July, ruling that Missouri’s Medicaid expansion ballot measure was constitutional. The state Department of Social Services (DSS) has said it needs two months and more employees to implement Medicaid expansion. Judge Beetem’s ruling does not address that, nor does it give a timeframe on how long DSS has to do it.

Judge Beetem has ordered DSS to post his ruling on DSS’ website, and to communicate the order to all employees.

Attorney Chuck Hatfield represents the three low-income women suing the state. His three clients are Stephanie Doyle of St. Louis, Melinda Hille of Fenton and Springfield’s Autumn Stultz. They suffer from diabetes and various skin conditions.

53 percent of Missouri voters approved Medicaid expansion in August 2020. However, it failed in 107 of Missouri’s 114 counties. The opposition to Medicaid expansion this year primarily came from rural GOP lawmakers who represent those districts. They say Missouri cannot afford Medicaid expansion.

Medicaid is a federal and state program that assists with medical costs for residents with limited incomes. Medicaid expansion supporters say it would help the working poor across the state. They say it will provide healthcare to Missourians who earn less than $18,000 annually.

Click here to listen to Missouri Governor Mike Parson respond to Brian Hauswirth’s question about Cole County Judge Jon Beetem’s ruling on Medicaid expansion. Brian spoke to Parson on August 10, 2021 at the governor’s Mansion about the Bicentennial events, and about the judge’s ruling:


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Parson: Missouri will follow judge’s order on Medicaid expansion (AUDIO) – Missourinet.com