“Because the General Assembly did not do so,” Sauer wrote, “defendants lack authority to implement Medicaid expansion and they lack appropriations authority to disburse taxpayer funds for that purpose.” Sauer also wrote that the availability of “additional federal funds to offset some of the costs of Medicaid expansion … does not make up for the lack of appropriations authority under state law to expend any funds, whether state or federal, for the purpose of implementing Medicaid expansion.” The case over Medicaid expansion is slated to begin later this month before Cole County Judge Jon Beetem. But whatever happens in that courtroom is almost certain to be appealed to the Missouri Supreme Court.