Missouri lawmakers were under no obligation to fund Medicaid’s expansion, and the courts cannot force the state to pay medical bills for those eligible under a constitutional amendment initiative, the Attorney General argued in documents, which were filed in Cole County on Monday county court.
The filing from the Office of Attorney General Eric Schmitt is the state’s response to a lawsuit filed on May 20 seeking an order to open Medicaid roles to approximately 275,000 working-age adults.
The lawsuit argues that the initiative established eligibility criteria; lawmakers seized funds for all covered Medicaid services; and denial of coverage is unconstitutional.
This claim, wrote attorney John Sauer for the state, gives “undue credibility to an intention which the legislature has categorically rejected”.
Legislature received and turned down a motion from Governor Mike Parson for $ 1.9 billion to cover costs, including $ 130 million in general revenue. Since an initiative could not appropriate existing income, argued Sauer, the legislature had the option of rejecting the expenditure.
A state order for medical care for the expansion group would violate the separation of powers between the judiciary and the legislature, wrote Sauer.
“The legislature has exclusive authority over the resources under the Missouri Constitution,” wrote Sauer.
The case will be open for discussion on June 18, and a verdict from District Judge Jon Beetem is expected before the new fiscal year begins on July 1. Prior to this trial, however, Beetem will hear a motion from two residents of St. Louis on Monday to intervene on the case.
The original plaintiffs’ attorneys, three people eligible for coverage under the initiative passed as Amendment 2 in August, could not be reached on Tuesday for comment on the new filing.
The interveners are two people who would also be eligible. Attorney Paul Martin wrote on his file that they should be heard because a verdict against the original plaintiffs “will affect and impede (the interveners’) ability to protect their federal and state interests”.
According to the terms of the amendment to the constitution, adults between the ages of 19 and 64 with an income of up to 138 percent of federal poverty are entitled to “medical assistance under the MO HealthNet and receive coverage for the health care package”.
That income level is $ 17,774 per year for a single person, equivalent to about 33 hours of work per week with a state minimum wage of $ 10.30 per hour. For a household of four, the limit is $ 36,570, the hourly income of one person who works full-time is $ 17.58 an hour, or two people who work 68 hours a week together at the minimum wage.
Under the current Medicaid program, adults without children are not eligible unless they are blind, have another qualifying disability, or are pregnant.
Before the initiative was passed, Missouri was one of 14 states that had not yet expanded Medicaid under the Affordable Care Act of 2010. The law originally made the extension mandatory, but the US Supreme Court ruled in 2012 that criminal provisions that made Medicaid an all-or-nothing program are unenforceable.
Under the terms of the ACA, the states pay 10 percent of the expansion costs and the federal government pays 90 percent. Missouri pays about 35 percent of the costs in the traditional Medicaid program.
By refusing to expand, Missouri is giving up an opportunity to raise approximately $ 1.2 billion in federal aid to the traditional Medicaid program. The American bailout plan, passed in March, increases the federal portion of the traditional program by 5 percent for states that expand Medicaid over the next two years.
The lawsuit alleges the state violated a provision of the Enlargement Amendment that requires the state to maximize federal funding for Medicaid. A promise of additional federal funding to expand Medicaid does not bypass lawmakers’ power over spending, Sauer wrote.
“The availability of additional federal funding to offset some of the cost of Medicaid expansion claimed in the petition does not offset the lack of state law granting powers to spend funds,” he wrote, “whether federal or state purpose of Medicaid expansion . “
The Missouri Independent is a non-profit, non-partisan news organization dedicated to researching state government and its impact on Missouri residents.