Missouri’s Medicaid extension is back on track

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Gov. Mike Parson, a Republican, then said he was unable to implement it.

Groups supporting the expansion of Medicaid have turned to the courts for redress. A lower court ruled in favor of the state, ruling that lawmakers were not required to allocate funds to expand Medicaid. But the Missouri Supreme Court ruling now overturns that ruling.

The court said the state’s Medicaid program was now bound by the voting initiative “regarding who is eligible to enroll,” regardless of appropriation decisions made by the legislature.

The new ruling orders the lower court to work out the details of getting the new program up and running, but it’s unclear exactly when Missouri will begin enrolling patients. Kelli Jones, spokesman for Governor Parson, said in an emailed statement that the governor did not believe he had “the necessary budgetary authority” to implement the expansion and that he was “considering the available options “.

Because of its timing, Missouri’s involvement in the Medicaid expansion is actually likely to leave the state in better financial shape, at least for the next two years. That’s because the new federal stimulus funds, available to states that are expanding Medicaid this year, will cover the state’s 10 percent share of the program – and then some.

The state will receive about $ 1 billion over two years in additional funds for the expansion of Medicaid, according to an estimate from the Kaiser Family Foundation. Last summer, before those funds existed, the Missouri state auditor estimated that the Medicaid expansion would cost the state a maximum of $ 200 million.

Missouri is the second state to receive new stimulus funding from the American Rescue Program, after Oklahoma, which opened its Medicaid expansion on July 1 after also adopting a voting initiative in 2020. Both states adopted their voting initiatives before the creation of these stimulus funds. .

The Fairness Project, a national nonprofit organization that helped organize the Medicaid voting initiative in Missouri and other states, is now aiming to put the issue up for a vote in South Dakota in 2022. groups collect signatures there before the September deadline.


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