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SLU LAW’s History with Medicaid Expansion Continues with Student-Built Helpline

by Elliot Laurence

It has been nearly 11 years since Saint Louis University School of Law’s Health Law, Policy and Advocacy course, founded by Professor Sidney Watson, began working towards Medicaid expansion in Missouri. This year, the effort of countless SLU LAW faculty, students and alumni finally came to fruition.  

Professor Watson spoke of the history of Medicaid expansion in the state.

“Missouri [passed] a ballot initiative to make Medicaid expansion a constitutional right," he said. "It passed with 63% of votes statewide to be implemented on July 1, 2021. Except things didn’t go exactly as planned. It took a lawsuit to force the state to implement the ballot initiative, effective August 10, 2021. That lawsuit was filed by several accomplished, high-profile lawyers and a lot of young lawyers. Three of those key young lawyers were graduates of the course.” 

With over a decade of student involvement in advocating for Medicaid expansion, the course has created an indelible mark.

Geoffrey Oliver (‘13) took the first edition of the class. Currently, he is a program director for the Legal Services of Eastern Missouri (LSEM). His experiences in Medicaid span from his time at SLU LAW to across the states. He assisted Colorado with its own version of the health care program. Oliver’s return this year to co-teach the class was met with nostalgia and the aftermath of success.

“It was very different,” Oliver explained. “During my 3L year, the class was about advocacy. This time it was about implementation. It was fantastic to see how much had changed.”

With Medicaid expansion passed and enrollment open, the work was not over. Professor Watson’s 2021-2022 students knew this well as they took on a new goal: building a Medicaid Expansion HelpLine to assist those applying for coverage.

In total, eight students took the fall 2021 and spring 2022 Health Law, Policy and Advocacy course. Professor Watson explained that the idea for the HelpLine emerged soon after the ballot initiative passed in August 2022 and was the brainchild of St. Louis Regional Health Commission’s Rosetta Keaton, who works as a patient advisory consultant.

“Rosetta Keaton spoke to a group of new students and an LLM health law student asked what they could do ... to help the Regional Health Commission,” Professor Watson said. “A few months later, Rosetta came back to me and said she thought we needed a Medicaid Expansion HelpLine. She thought the law students would be perfect to staff that HelpLine. It fell together in this sort of crazy way.

"When the trial judge entered the order requiring the state to implement Medicaid expansion effective August 10, it was like, okay, the first day of class is August 16. Rosetta said, we are going to build a HelpLine. Let’s go! Class alum Samantha Schrage, who was then a lawyer at LSEM, called and offered to co-teach the class. We just said, Let’s do it.” 

With the help of Rosetta Keaton and alumni returning as adjunct professors, Geoffrey Oliver and Samantha Schrage (‘16), the students created the HelpLine. 

Sometimes, we sat back and watched the students problem solve. They were an amazing team. They played to each other’s strengths and cover each other’s weaknesses."

Professor and Director of the Center for Health Law Studies, Sidney Watson 

“We knew that we weren’t going to come into class and tell [the students] how to do things, we were going to learn together," Professor Watson said. "Sometimes, we sat back and watched the students problem solve. They were an amazing team. They played to each other’s strengths and cover each other’s weaknesses. The students were coming out of 18 months of being at home. Some who started as first years last year didn’t know anybody. Now they have a friendship group. They have a really strong team,” 

Oliver agreed with the benefits of the course’s education style. With its emphasis on hands-on learning, he said that “in this case, we weren’t learning how to be accurate. We were learning how to take action.” 

Co-instructor Sami Schrage brought attention to the components of the project.

"Awareness is a really big piece," Schrage said. "The options have changed. Families that were denied two years ago need to know they can re-apply."

Previous course cohort, as both student and faculty fellow, Schrage additionally noted the students' dedication to the HelpLine.

"It was such a team effort," Schrage said. "It was so successful because each student had previous skills they brought to the table."

Among the spring 2022 student group was Caela Camazine. Rising 3L and a College of Public Health and Social Justice dual degree student, Camazine found her passion through the Medicaid Expansion Helpline project. 

“I really foresee myself sticking with this," she said. "I’m now equipped with knowledge that I can take out to the public. The way that we’ve been empowered to serve our community has luckily been very portable. I keep the Medicaid information card in my phone. I can take the knowledge I have now and use it.”

However, the school year has ended, and next year will bring new students and a new project. Despite this, the helpline is a constant need for those working on getting Medicaid.

To ensure no lapse in assistance, the Medicaid Expansion Helpline will be managed by the Regional Health Commission. And there will still be a SLU LAW presence while working on the transition; Camazine has joined on for her summer internship to continue the effort she started in class.

 “When the opportunity arose, it was absolutely perfect," she said. "I’m excited to continue to work on the helpline. I really like that it will be a dynamic internship because I think it’s going to prepare me for real life.” 

Camazine spoke about the inspirations within the course, both within the subject and the instructors.

“It’s so cool to be guided with those who were once sitting where I sat," she said. "It’s a reminder that the SLU Health Law community is really a community that extends past our days in school. It was comforting and reassuring and, more than that, empowering.”