Missouri court rules Medicaid expansion must begin immediately

Missouri officials must implement the voter-approved Medicaid expansion immediately, a state judge ruled Tuesday, rejecting a request from the attorney general's office for at least a two month delay.

The ruling by Cole County Circuit Judge Jon Beetem follows a unanimous ruling by the state's Supreme Court last month in favor of expansion. 

The Supreme Court overturned an earlier decision by Beetem blocking implementation, and remanded the case back to him to “issue a judgment for the plaintiffs.” 

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An estimated 275,000 people in Missouri are now eligible to gain Medicaid coverage.

Voters passed a ballot question last year approving the expansion of Medicaid under the Affordable Care Act, but when Republicans in the state legislature declined to provide funding for it, GOP Gov. Mike Parson said he would not implement it.

During arguments last week, the state argued it needed time to develop a plan to accept newly qualified people in the Medicaid program. 

However, Parson had initially submitted a plan for expansion to the federal government before withdrawing the paperwork in May.    

The constitutional amendment passed with 53 percent of the vote during the November election. It makes adults between the ages of 19 and 65 eligible for Medicaid if they make 133 percent of the federal poverty level — or about $35,200 for a family of four. It also prohibits the state from enacting work requirements for Medicaid recipients.

Democrats in Congress are currently exploring ways to have the federal government step in and provide coverage in the 12 GOP-led states that have not expanded Medicaid. The Senate Democratic budget resolution will include a mechanism for doing so, but the details remain to be seen.