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missouri medicaid expansion

FGA Responds to Missouri Judge’s Decision to Strike Down Medicaid Expansion Ballot Initiative as Unconstitutional

Today, the push for Medicaid Expansion was dealt a major blow as Judge E. Beetem found the Medicaid Amendment unconstitutional. The decision to expand Missouri’s Medicaid programs came from a ballot initiative narrowly passed in August of 2020. 

In his order, Judge Beetem took issue with the initiative’s failure to include a funding source for the millions of taxpayer dollars it would take to provide the services required. Citing that the Missouri Constitution requires any ballot initiative that expends state resources to include funds necessary to pay for those services.

“Today’s ruling is a major victory for Missouri and restores the integrity of the ballot initiative process which is protected by the Missouri Constitution,” said Chase Martin, Legal Affairs Director for FGA. “Judge Beetem saw through the deceptive ballot initiative language and took the necessary steps to restore the rule of law and protect the integrity of the lawmaking and appropriation process in Missouri.”


The Foundation for Government Accountability (FGA) is a non–profit, multi–state think tank that specializes in health care, welfare, work, and election reforms. To learn more, visit

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