A judge in mid-Missouri’s Cole County will hold a hearing Monday afternoon in Jefferson City involving a lawsuit filed by three women who want the state to fund Medicaid expansion. The plaintiffs note Missouri voters approved Medicaid expansion in August.

Cole County Circuit Judge Jon Beetem speaks in court in Jefferson City on July 5, 2018 (file pool photo courtesy of “News-Tribune” photographer Mark Wilson)

Medicaid, which is officially known as MO HealthNet, is a federal and state program that assists with medical costs for residents with limited incomes.

The three women, Stephanie Doyle of St. Louis, Melinda Hille of Fenton and Autumn Stultz of Springfield, are suing the state for not funding Medicaid expansion. 53 percent of Missouri voters approved Amendment Two in August.

The lawsuit wants the state Department of Social Services (DSS) to allow Doyle, Hille and Stultz to enroll and receive the same Medicaid coverage as those who currently receive it.

The plaintiffs are represented by several attorneys, including Chuck Hatfield, Lowell Pearson and Alixandra Cossette. During a May interview with Missourinet, Counselor Hatfield said his clients have serious health problems, including asthma, tonsil stones, type one diabetes, thyroid disease and a severe skin condition.

The Missouri Legislature gave final approval in May to a $35 billion state operating budget, a budget that does not contain funding for Medicaid expansion. GOP lawmakers, led by House Budget Committee Chairman Rep. Cody Smith (R-Carthage) say the money is best spent on the most vulnerable, including those with developmental disabilities. Smith’s alternate plan, which was approved by lawmakers, contains millions of dollars in additional funding for those with developmental disabilities. It also includes millions for long-term care in nursing homes, adult day care and home-delivered meals.

Chairman Smith and other anti-expansion supporters say the Amendment Two ballot measure did not contain a funding source, making it unconstitutional.

Cole County Circuit Judge Jon Beetem will hold a hearing at 1 Monday in Jefferson City. Counselor Hatfield is the main attorney for the three plaintiffs, and DSS is represented by state Solicitor General D. John Sauer and Assistant Attorney General Jesus Osete.

Judge Beetem is not expected to issue a ruling at Monday’s hearing, which will receive major news media coverage across the state. Numerous media outlets plan to be at the Cole County Courthouse for the the hearing.

There are essentially two battles involving Medicaid expansion: one is the court lawsuit that Judge Beetem will hear. The second is a political battle that will likely be an issue in Missouri’s 2022 elections.

Legislative supporters of Medicaid expansion say it would help the working poor across the state. They say Amendment Two would provide healthcare to Missourians who earn less than $18,000 annually.

While it passed statewide with 53 percent of the vote, Amendment Two failed in 105 of Missouri’s 114 counties. The opposition to Medicaid expansion has primarily come from rural lawmakers in districts that voted against Medicaid expansion.

State Rep. Dirk Deaton (R-Noel) took exception to comments from House Democrats during May’s floor debate. Noel is located in southwest Missouri’s McDonald County, which voted against Medicaid expansion.

“And I take issue and I wonder if you (State Rep. Hannah Kelly, R-Mountain Grove) do, with the thought that we don’t know what’s good for own counties and our people. Rural Missouri voted overwhelmingly against Medicaid expansion, but yet we seemingly are too backwards to know what’s good for us,” Deaton said that day on the House floor.

During May’s floor debate, State Rep. Sarah Unsicker (D-Shrewsbury) said there are 21 rural Missouri counties where more than 20 percent of the adult population is uninsured, including in northeast Missouri’s Scotland County. Unsicker says one of three adults there is uninsured.

“Oregon, Shannon, Knox, Ripley, McDonald, Morgan, Ozark, Cedar, Taney, Dunklin, Douglas, New Madrid, Wayne, Mississippi, Crawford, Carter, Wright, Grundy, Texas and Pemiscot counties,” Representative Unsicker said that day, on the floor.

She says residents in those rural counties would benefit the most from Medicaid expansion. Ten rural Missouri hospitals have closed since 2014.

The number of Missourians receiving Medicaid has increased for 11 straight months. The DSS website says the number has increased from 939,919 in June 2020 to 1,080,576 in May. That’s an increase of 140,657.

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