Victory in Missouri: The Missouri Supreme Court ruled unanimously against the Missouri Legislature that the Medicaid eligibility in Missouri must be expanded, which could impact as many as 275,000 Missourians.

The background: Last August, voters in Missouri approved expanding Medicaid by a vote of 53-47%. The vote joined Missouri with the 38 other states who had approved Medicaid expansion under Obamacare/ACA. The cost estimates for the bill in the ballot language indicated a range of a cost of $200 million to a savings of $2 billion (since the federal government pays 90% of the expansion costs, the measure is expected to be revenue-positive for the state; hospitals in the state are estimated to have lost $6.8 billion from 2013-2022 from the state not expanding eligibility, and the state has given up $17.8 billion in federal expansion money)

As it has with numerous previous voter-approved constitutional amendments, such as anti Right-to-Work and anti-gerrymandering measures, the Republican supermajority in the legislature ignored the will of the voters, refusing the fund the expansion approved by voters.  A $167 million funding proposal to support the expansion in Republican Gov. Mike Parson’s proposed FY2022 budget was shot down, leading to the showdown in court.

A court in June ruled the Medicaid expansion vote was unconstitutional, since it did not contain a mechanism for funding the expansion.  The case was then fast-tracked to the Missouri Supreme Court, which ruled 7-0 yesterday that it was constitutional, making thousands more of Missourians immediately eligible for Medicaid coverage.

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