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Judge to decide on Missouri Medicaid expansion lawsuit this week

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JEFFERSON CITY, Mo. — Attorneys for the three plaintiffs who sued the state for refusing to enact the voter-approved Medicaid expansion want a judge to order they can enroll in the program.

Cole County Circuit Court Judge Jon Beetem said at Monday’s hearing he will likely issue a decision by Wednesday.

Monday’s hearing came down to interpretation.

The plaintiff’s attorneys, led by Chuck Hatfield, argued that the Missouri constitution states their clients and other Missourians are eligible for Medicaid coverage under the expansion.

Hatfield said there is already funding for it in appropriations for things like pharmacy and physicians services.

He told the judge to look at the Planned Parenthood ruling from last year, when the Missouri Supreme Court ruled the legislature couldn’t use appropriations bills to block Planned Parenthood from using family planning funding to provide medical services for folks on Medicaid.

The attorneys representing Missouri Health Net, or Medicaid, said that the money is not for the expanded population, just the existing population.

John Sauer, arguing on behalf of Attorney General Eric Schmitt’s office, said there isn’t enough money for expansion and he’d expect lawmakers to make such a huge decision with clarity.

He told the judge to consider what a “reasonable reader” would think when looking at the constitution.

Sauer argued eligibility is different than funding.

“There was a campaign. There was a lot of money spent educating people on this. The constitution was amended,” Hatfield said. “There is no such thing as an expansion population or a preexisting population. There is just Medicaid coverage and our plaintiffs are in that group.”

Hatfield said there’s no way to tell how many of the 275,000 newly-eligible people will actually enroll, but the constitution says they can and argued the state can fund it.

“We've asked the judge to enter into an injunction to allow our plaintiffs and those like them to be enrolled in the Medicaid program on July 1,” Hatfield said. “We assume that if the judge were to enter that injunction, the state will obey and begin to enroll people July 1. We'll have to wait and see how that shakes out.”

If the judge doesn't rule in the plaintiffs favor, Hatfield said they plan to take it to appeals court and even the Supreme Court.

Joel Ferber with Legal Services of Eastern Missouri said his clients have debilitating health conditions that they could treat by having Medicaid coverage.