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Missouri deems Medicaid expansion lawsuit an 'attempt to circumvent' constitutional requirements

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KANSAS CITY, Mo. — In response to a lawsuit regarding Missouri’s backtracking on Medicaid expansion, the state's attorney general alleged that the suit’s interpretation of state law is “an impermissible attempt to circumvent bedrock constitutional requirements.”

Filed June 4, Eric Schmitt argued that the lawsuit, filed by three women who qualify for Medicaid coverage, is “premised on an incorrect statutory interpretation of HB 11 and other appropriations statutes enacted in the 2021 session of the General Assembly.”

Missouri voters initially approved in August a constitutional amendment for the expansion, but Gov. Mike Parson announced in May that the state would not move forward, citing a lack of funding.

The court documents, filed in Cole County, stated that the House bill’s plain text confirms that the funds were not appropriated through HB 11, which covers the Department of Social Services, or any other bill for Medicaid expansion.

“Under Article III, Section 51 of the Constitution, the constitutional amendment purportedly authorizing Medicaid Expansion could not and did not mandate an appropriation,” court documents state. “Rather, the General Assembly retained authority to appropriate, or not appropriate, funds for Medicaid Expansion. Because the General Assembly did not do so, Defendants lack authority to implement Medicaid Expansion and they lack appropriations authority to disburse taxpayer funds for that purpose.”

The voter-approved expansion included language stating that the federal government would reimburse the state for a majority of the expansion costs.

But the state argued that using federal funds to offset some costs associated with Medicaid expansion “does not make up for the lack of appropriations authority under state law to expend any funds, whether state or federal, for the purpose of implementing Medicaid expansion.”

Additionally, the state said that granting the plaintiff’s relief request would “violate the separation of powers provision of the Missouri Constitution.”

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