Missouri’s government did not want to expand Medicaid. The state’s institutional structure allowed for a blocking coalition to stand firm for a decade.
The voters of the state approved a state constitutional amendment ordering the governor to file a state plan amendment to cover the expansion population.
The legislature refused to appropriate funds to pay for the coverage expansion.
Individuals who are eligible to enroll for Medicaid Expansion sued in state court.
A few weeks ago, a state district judge ruled that the constitutional amendment which passed Medicaid expansion was fatally flawed as it commanded the legislature to spend money.
On Thursday, in an unanimous decision, the state Supreme Court disagreed. They ruled that the constitutional amendment ordered the governor file for expansion and did not order an appropriation of state funds. The legislature can either appropriate funds or let the entire program run out of cash at some point in the next year. That is their choice.
1. Thank God
2. As cited in this article, the key is a directive to the Missouri exec. branch to cover the expansion population. The legislature does not have to appropriate funds for Missouri Medicaid to have an obligation to fund people entitled to coverage under Missouri law. https://t.co/kjMjGHsxPD
— Eliot Fishman (@FishmanEliot) July 22, 2021
So sometime in the next few weeks to months, hundreds of thousands of more Missourians will get health insurance. More will get better coverage. And as a kicker, the state of Missouri will be paid, on net, almost a billion dollars in general fund revenue by the federal government, to overpay for health insurance for the working poor.