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3 Missourians file lawsuit after Parson nixes Medicaid expansion

Governor cited lack of funding from legislature
Posted at 3:36 PM, May 20, 2021
and last updated 2021-05-20 17:25:01-04

KANSAS CITY, Mo. — Three Missouri residents who qualify for Medicaid coverage have filed a lawsuit, alleging that there is no reason the state cannot fund the voter-approved expansion of the federal low-income medical insurance program.

Gov. Mike Parson announced last week that the state would not expand due to a lack of funding from the legislature. Missouri voters passed a constitutional amendment last August to expand Medicaid in the state.

Earlier this month, the state legislature approved a $35-billion budget with no additional funding allocated for the expansion, which would cover an additional 275,000 Missourians at a cost of roughly $200 million in state monies.

Stephanie Doyle, Melinda Hille and Autumn Stultz named the Missouri Department of Social Services and its acting director, Jennifer Tidball; MO HealthNet Division and its acting director, Kirk Mathews; the state’s Family Support Division and its director, Kim Evans.

The trio alleges that the agency's claims of not being able to implement the expansion without a specific line item in budget appropriations has “no merit.”

RELATED: Health services CEO: Missouri Medicaid decision an 'embarrassment'

“The DSS appropriations bill does not limit any MO HealthNet funding for coverage of particular categories of eligible individuals,” the lawsuit said. “Nothing in the DSS appropriations bill prevents the agencies from using appropriated funds to cover individuals whose eligibility arises under the Constitution. In other words, DSS, the MO HealthNet Division, and the Family Support Division have full authority to implement Medicaid Expansion as directed by the Missouri Constitution.”

DSS responded, according to the court documents that cite a letter to the Centers for Medicare and Medicaid Services, that, because funding was not appropriated and the petition itself was not self-funded, it couldn’t move forward.

The Doyle, Hille and Stultz lawsuit argues that refusing to extend benefits is unlawful, “because there is an authorizing constitutional amendment and an appropriation for this program.”

In response to the lawsuit, the Missouri Budget Project said in a statement that "it's clear" Medicaid can be implemented in the state.

"Simply put, Missouri funds the health services provided through Medicaid – it does not fund specific population groups," the statement read. "While next year’s state budget doesn’t have a line item for Medicaid expansion adults, it doesn’t have line items for pregnant women, children, or people with disabilities either. Whoever is eligible for Medicaid can be enrolled and receive services."

Days prior to the lawsuit being filed, the state filed a rule to amend and comply with Medicaid expansion. The proposed amendment would "clarify DSS's existing regulation governing presumptive eligibility" and ensure that those who meet requirements are provided coverage. It also would have "no fiscal impact since it does not substantively change anything the department is not already doing."

Under the voter-approved expansion, residents between 19 and 65 years old whose income is “at or below 138% of the federal poverty level” qualified for Medicaid, and the federal government would reimburse the state for 90% of the cost of the expansion.