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Court to Missouri Republicans: No more Medicaid expansion delays

Missouri voters approved Medicaid expansion. Missouri Republicans said they didn't care. A Missouri Court said the GOP doesn't have a choice.

Missouri residents voted last year to bring Medicaid expansion to their state. It's taken far too long, but as the Associated Press reported, the benefits are finally going to reach the people who need them.

A Missouri judge on Tuesday ruled that Republican Gov. Mike Parson no longer can deny Medicaid health care to thousands more newly eligible adults. Cole County Judge Jon Beetem in his order said Parson's administration must give Medicaid coverage to newly eligible adults, despite the governor's resistance to doing so. Beetem also ordered that newly eligible adults won't face any additional restrictions to get health care coverage through the program.

To appreciate the significance of the ruling, let's revisit our earlier coverage and review how we arrived at this point.

By any fair measure, Republicans in Missouri had reason to be delighted with the 2020 election cycle. Donald Trump won the state by 15 points; Gov. Mike Parson (R) cruised to a similarly lopsided victory; GOP representatives won six of the state's eight congressional seats; and Republicans continued to dominate in both chambers of the state legislature.

But while Missouri may be earning its reputation as a ruby-red state, the electoral news for Republicans last year wasn't all good. Last summer, during the state's Aug. 4 primaries, a majority of Missouri voters approved Medicaid expansion -- a decision that was poised to extend health security to roughly 275,000 low-income Missourians currently going without.

GOP officials urged voters to reject the ballot measure. A 53% majority of the state's voters rejected the advice and passed it anyway.

That appeared to be the end of the fight, but it wasn't. Instead, Missouri's Republican-led state government decided it would simply ignore the election results and refuse to enact the voter-approved policy.

Legal fights soon followed, and as Rachel explained on the show last month, the seven justices on the Missouri Supreme Court rejected the GOP's approach, telling state policymakers that honoring the results of the ballot referendum is not optional.

"It is tempting to ask Republican state legislators who disobeyed the will of the people to apologize for their misunderstanding of the law, and the people," the editorial board of the Kansas City Star wrote. "The decision to refuse to allocate funds for Medicaid expansion clearly violated the state constitution, while slapping voters in the face."

The editors added, "It took some time, but the Missouri Supreme Court has said what everyone knew: The voters had a right to require Medicaid expansion, which they exercised. In Missouri, the people still rule -- not lawmakers who think the poor should suffer in silence."

That, however, was three weeks ago -- and in the time since, Republican officials still didn't quite get around to implementing the policy.

This week, a Missouri judge announced there could be no more delays. The state has to follow the law. Period. Full stop.

Of course, there are some practical considerations. The Associated Press report added, "It remains unclear how the state will pay for health care for the newly eligible recipients. The Legislature may have to hold a special session to set aside more money for Medicaid. Otherwise, the state risks running out of funding for the program."

It sounds like the sort of thing Republican officials should've started working on months ago, instead of ignoring the results of a statewide referendum the party didn't like.