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After court ruling, 275,000 Missourians are now eligible to sign up for Medicaid expansion

After a court ruling, Governor Parson states, "My administration is always going to follow the law and yesterday's court order is no exception"

ST. LOUIS — For months, a battle took place over Medicaid expansion in the Show-Me State. 

In the last 24 hours though, a decision has been made.

A Missouri judge has ruled on Tuesday, Governor Mike Parson no longer can deny Medicaid healthcare.

COVERAGE

It would impact 275,000 Missourians.

Those eligible include ages 19-65 earning up to 138% of the federal poverty level, which is less than $17,774 annually for an individual or less than $37,570 for a family of four.

HOW WE GOT HERE

In August 2020, 53% of Missourians, or 676,000+ people voted in favor of Medicaid expansion, also known as MO HealthNet in Missouri.

It was supposed to kick in on July 1. 

In February, Governor Parson and the Missouri Department of Social Services (DSS) sent the Centers of Medicare and Medicaid Services a state plan explaining they were going to go through with the expansion. 

DSS estimated it would cost $1.9 billion to fund the expansion in the 2022 fiscal year budget. Then, Governor Parson included the suggested funds in his annual budget proposal to the General Assembly. 

Several Republicans argued it would cause the state to pay for an expensive program causing a financial blow for future budgets.

The House voted to not fund it and in April, the Senate sealed the deal by blocking the funding.

On May 7, the legislature did not include the funding for its expansion in this year's budget.

In turn, Governor Parson said, that meant they couldn't expand Medicaid.

The battle went to the courts.

THE LAWSUIT

After being refused on July 1, three women who were newly eligible for Medicaid sued.

Chuck Hatfield with Stinson Law in Jefferson City partnered up with the Legal Services of Eastern Missouri, or LSEM, to help the three clients.

LSEM is a nonprofit legal aid organization serving 21 eastern Missouri counties, helping low-income families.

On July 22, the Missouri Supreme Court agreed with the voter-approved plan to stay in place claiming the money is there.

The state Supreme Court ruled it did not violate the Missouri Constitution because it "does not appropriate money and does not remove the General Assembly's discretion in appropriating money to MO HealthNet."

Hatfield says, "This isn't really about whether you have the money to provide the care, this is about where the legislature is going to give them the budgetary authority to spend the money."

The Supreme Court sent it back to the trial judge.

Last Friday, the lawyers spoke with the Cole County Judge Jon Beetem to go over what the Supreme Court issued.

"The state said that they needed two more months to implement the Medicaid program even though we all voted on it last August," Hatfield says. "We argued they should not give them another two months, so the judge should go ahead and order them to begin the enrollment process right now."

Judge Beetem followed that and implemented it on Tuesday. 

In a press release Wednesday, Governor Parson stated, 'My administration is always going to follow the law and yesterday's court order is no exception'.

Credit: KSDK

Melinda Hille is one of the women in the lawsuit and one of the people benefiting.

She tells 5 On Your Side:

"Yesterday's ruling was such a blessing. I feel like, after having to fight literally for my life for five years, after being diagnosed with diabetes, I won the lottery! Because I couldn't get medicaid, I was unable to get adequate healthcare. Unfortunately my health has declined because I couldn't get adequate healthcare. But I feel like this is a huge win and pray that no one has to go through what I've had to for the last 5 years. When you have a disease or long-term illness, you're supposed to be proactive, but due to lack of insurance I could only be reactive. People think we want a handout. Not true. I've worked two and three jobs, went to college and have always tried to give back. If I would have had Medicaid in the beginning, things wouldn't have gotten so severe and I could still be productive. Hopefully this will help the 250,000 people in my same boat."

HOW TO APPLY                                                    

Joel Ferber is the director of advocacy for LSEM and says, "Definitely get an application and expect it to take some time."

Ferber explains, if you were denied on July 1 or a date following that, the state should be going through those rejected applications for Medicaid expansion. 

He says their office is assisting folks and to call 314-534-4200 if you need help.

Hatfield says, "If folks have urgent healthcare needs, the hospitals, the doctors' offices, and the clinics will help them through the process. The providers that are giving them that care will help them with the application process and they'll almost certainly be able to get care under what's called presumptive eligibility."

If they don't have urgent needs, he adds the best thing to do is to go to the local department of social services office.

You can also go online and apply here

WHAT'S NEXT?

State Representative from St. Louis Rasheen Aldridge (D-St. Louis) wants to make sure the right steps are being taken to fund the expansion.

"It's something that we really need to go back to session and tell the people of the state of Missouri that we heard you. We didn't get it done during our regular time, but we did get it done now, after the court case," he says. 

As a member of the budget committee, Aldridge is ready to work.

He adds, "It helps people that are uninsured. It helps individuals that live in districts like mine, that don’t have access to quality healthcare. This is something that the voters of the state went out and said they want it. Some legislators thought that they were smarter than the people."

Senator Bob Onder, R-Lake St. Louis, also weighed in. He hopes they will have another special session to explicitly restrict Medicaid expansion enrollees under Obamacare from being included in Missouri's expansion.

As for the state, it says the system update is anticipated to take up to 60 days because it's limited in staffing and funding. 

In a press release, it says they are working through administrative hurdles, including adequate appropriations, staffing capacity, and computer software changes in order to begin enrolling the expanded population. 

It mentions, Governor Parson included funding this in his budget proposal.

But since, the proposed funds weren't included in that budget, DSS is limited to administering the expanded program without sufficient staffing or money.

In order to comply with the court order and until the necessary funds can be met, DSS will reassign existing employees from their current assignments and responsibilities in order to receive and evaluate applications.

They add, qualifying health care costs that are incurred by eligible Missourians between the time they apply and when DSS is able to verify their eligibility may be reimbursed at a later date.

House Minority Leader Crystal Quade weighs in on Twitter: