A Missouri judge on Wednesday ruled against a lawsuit seeking to force the state to implement Medicaid expansion under the Affordable Care Act, a setback for supporters of expansion.
The ruling will be appealed, though, meaning it is not the final word.
Missouri voters passed a ballot measure last year to expand Medicaid, but GOP Gov. Mike Parson said in May he would drop plans to expand the program after the Republican-controlled legislature declined to provide funding for it.
Supporters of Medicaid expansion sued, seeking to force the state to expand the program starting July 1, which would provide health insurance to about 275,000 low-income people.
Judge Jon Beetem ruled against the lawsuit on Wednesday, writing that the voter-approved ballot measure was actually unconstitutional, since it sought to spend state funds without identifying a funding source, infringing on the legislature's appropriations power.
"It is unfortunate that, yet again, hundreds of thousands of Missourians will have to wait even longer to access the health care they need," Dwayne Proctor, CEO of the Missouri Foundation for Health, said in a statement.
Supporters of expansion said they would appeal.
The setback for expansion in Missouri comes as congressional Democrats are exploring ways to go around states and expand the program in the 12 states that have still not accepted expansion.
A federal program to provide coverage in those states could be included in an upcoming legislative package.