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UMKC law professor explains Missouri Medicaid expansion ruling

'The people don't have the authority'
KC Medicaid expansion rally
Posted at 10:56 PM, Jun 23, 2021
and last updated 2021-06-24 00:01:32-04

KANSAS CITY, Mo. — A Missouri judge determined that the voter-approved Medicaid expansion amendment not only omitted how the expansion would be paid for, but that people don't have the power to tell the legislature how to spend the state's money, according to one University of Missouri-Kansas City law professor.

"So he takes the position he's not going to order it, that a court doesn't have that authority," Ann Marie Marciarille, a UMKC Law School professor, said of Cole County Circuit Judge Jon Beetem's ruling. "As well, not only did the people in the way this amendment was crafted didn't have the authority. He doesn't have the authority to tell the legislature, 'OK, now you're going to use your appropriation authority this way.'"

On the flip side, she said voters aren't exactly telling lawmakers how to spend money, because there's already money budgeted for Medicaid, much of that coming from the federal government.

Beetem's ruling stated that Gov. Mike Parson and state lawmakers can refuse to find a way to pay for Medicaid expansion. Missouri voters approved the expansion, which was supposed to go into effect next month, in August, but lawmakers never funded it.

Beetem ruled the law was never violated because the approved amendment didn't list how the state would pay for the expansion.
Those behind the lawsuit plan to appeal.

The expansion would have just allowed more people, including those who are single and working low-income jobs, access to Medicaid.

Marciarille also said not only will this likely go to the state Supreme Court, the entire country is watching this issue, as it could set a precedent for referendum's in the future and how voters can influence how funds are spent.

"I think it’s important enough that people are all over the country will be talking about this opinion and following it up through the appellate level," Marciarille said. "This isn’t just some arcane, Missouri constitutional law (although there are elements of that.) This is about, 'So how do people make change by referendum if they’re not able to make it through the traditional legislative process?' which is really the backstory here. Why did the people behind Amendment 2 go to the referendum? It’s because the other ways didn’t work."