February 2021 legislative update

This monthly legislative update follows important issues moving through legislative sessions in Kansas and Missouri. We welcome the opportunity to collaborate with partners that share similar interests. Contact us if there are opportunities to work together to strengthen our collective advocacy voice.

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KANSAS

The last day for the Kansas Legislature to file bills was in February, and they have now moved into turnaround week. This is the deadline for all non-exempt bills to complete their process in the originating chamber and move to the other legislative chamber. 

Health Forward met with Gov. Laura Kelly and senators in February to discuss policy priorities and offer our support in health-related matters. We saw movement on numerous issues that are important to us, and we expect to see more in March. Here is what we were following in February: 

Medicaid expansion

Last week, Gov. Kelly’s Medicaid expansion bill was introduced in the House’s Federal and State Affairs Committee. Rep. Brandon Woodard introduced the bill, which is awaiting a number, fiscal note, and summary. We commend Gov. Kelly for her leadership on health care access for those without insurance, and we are awaiting more information on what the bill entails.

Kansas could receive an estimated $330 million incentive from the federal government to expand Medicaid.  The next federal COVID relief package that was passed by the U.S. House of Representatives includes a 5 percent increase in the based Medicaid match rate for two years as an incentive for the remaining 12 states that have not expanded Medicaid. The budget reconciliation process for the federal relief package is expected to wrap up by mid-March, before the benefits from the prior package run out. 

COVID-19 vaccine distribution

Kansas is currently vaccinating individuals up to Phase 2, which includes high-contact critical workers and those working on congregate settings. The vaccination schedule is expected to move into Phase 3 in March. The next phase will add individuals between 16-64 with severe medical risks and other critical workers. The Kansas Department of Health and Environment reported more than 580,000 doses of the vaccine have been administered as of the end of February. 

As of March 1, approximately 13.5 percent of the population has received at least one dose of the vaccine, and over 190,000 Kansans have been fully vaccinated by both doses. 

Supplemental Nutrition Assistance Program

The House Committee on Children and Seniors passed the SNAP Assistance Requirement Bill out of committee on Feb. 25. HB 2371 removes cooperation with child support from the requirements for food and child care assistance, and also exempts adults enrolled in school from the work requirement for child care assistance. Health Forward, along with a coalition of over 30 other Kansas organizations led by Kansas Action for Children, submitted testimony in favor of this bill.

Removing cooperation with child support from eligibility requirements for access to public benefits would be a much-needed relief for all Kansans facing financial hardship exacerbated by the pandemic. An individual’s ability to receive critical supports, such as SNAP, should not be connected to their ability to pay child support. Cooperation requirements leave families more vulnerable and threaten children’s lives as well as custodial and non-custodial parents’ well-being. The bill moves to the House floor this week, and it is expected to garner significant opposition. 

Telehealth

HB 2206 was heard in early February by the House Committee on Health and Human Services. The bill relates to the Kansas telemedicine act but excludes any reference to payment parity. The committee deferred voting on the bill until interested parties are able to compromise on whether telehealth payment parity will be added to the bill. In addition to adding payment parity language to the bill, Health Forward hopes the temporary provisions for telehealth the Governor effectuated through executive order are made permanent. 

Rural Emergency Hospital Act

Health Forward has been following HB 2261, which would establish rural emergency hospitals as a rural health care licensure category. This is an issue that has been discussed for many years, and would be a step in the right direction to improve access to health services in rural communities by creating a category of licensure to enable certain Kansas hospitals to receive federal reimbursement as rural emergency hospitals. The bill passed out of the House Committee on Health and Human Services on Feb. 17 and moves to the Senate. 

MISSOURI

Health Forward met with legislators from our service area to discuss our policy priorities, including Medicaid expansion implementation, and the need to standardize the collection of disaggregated public health data across the state. The House Budget Subcommittees will begin to propose changes to the Governor’s budget in the next few weeks. We expect to see budget decisions throughout March, particularly as additional federal dollars head to states once the next relief package is passed at the federal level. The deadline to file new bills was March 1, and Spring Break will be from March 15-19. Here is what Health Forward was following over the past month:

Medicaid expansion 

The next federal COVID relief package includes a 5 percent increase in the base Medicaid match rate for two years as an incentive for the 12 states that have not expanded Medicaid. The budget reconciliation process for the federal relief package is expected to wrap up by mid-March, before the benefits from the prior package run out. The additional increase in state match would benefit Missouri as a newly expanded state.

Additionally, the federal emergency declaration for the pandemic means that the federal share of Medicaid increased by 7.62 percent for all states during 2020 and is likely to continue through 2021. These two changes in Medicaid reimbursement would reduce the state’s cost for the existing program by approximately $2 billion over the next two years. 

COVID-19 vaccine distribution

Missouri is currently vaccinating up to Phase 1B – Tier 2. Gov. Mike Parson announced that we will move to Phase 1B – Tier 3 on March 15. This move makes approximately 550,000 more Missouri residents eligible to receive a vaccine.

Health Forward had previously sent a letter to Gov. Parson urging the administration to elevate K-12 educators and school employees on the tier list. With schools opening back up for in-person learning across the state, our educators need to be prioritized for vaccinations. We are pleased that they will be eligible within Phase 1B – Tier 3.

In addition to educators, vaccinations will be available to child care providers, grocery store employees, and energy, food, agriculture, and other critical infrastructure workers. 

As of March 1, approximately 14 percent of the population has received at least one does of the vaccine, and over 440,000 Missourians have been fully vaccinated by both does. 

Public health authority

Several circulating public health authority bills would limit local health department control to make critical decisions during times of emergency. A substitute bill in the Senate combined different provisions from all the bills, but has been held off for a vote in executive session. There appears to be a division between legislators around what should be included in the bills moving forward. It is unclear how much traction these bills will receive moving forward, but we are following their progress closely. 

We will advocate against unnecessarily constraining the ability of local departments to respond to crisis. The COVID pandemic has highlighted the need for swift movement and flexibility in creating local solutions to public health challenges, balanced with a statewide perspective.  

Disaggregation of public health data

Health Forward worked with Sen. Barbara Washington to draft language for SB 543, which was introduced and first read on Feb. 24. The bill requires DHSS, local public health departments, all health care institutions, and all laboratories to collect and make publicly available demographic data that includes race, ethnicity, primary language, gender identity, age, disability status, and socioeconomic status.

The disaggregation of data is a necessary piece for accurately identifying health inequities, and a critical component of policymaking to address systemic injustices. We are pleased this bill was introduced, and will be advocating for its passage.   

Federal Reimbursement Allowances (FRA)

We saw no movement of the FRA sunset in February. The Senate Appropriations Committee met in January to hear legislation extending the FRA sunset two years. This is a public-private partnership model where hospitals provide funds to the state, and MO HealthNet uses these funds to earn federal matching dollars. Over the years, the FRA program has evolved to maximize matching dollars and reduce the burden of MO HealthNet on state general revenue. Since it has a significant impact on the budget, we are watching it closely. SB1 was voted out of committee in January, and was placed on the Senate Floor Calendar to come up for debate among the entire Senate. 

Supplemental Nutrition Assistance Program

SB 138 modifies the Supplemental Nutrition Assistance Program (SNAP) to impose lengthy disqualification periods on recipients who do not meet the work requirements. SNAP provides sustenance for many Missouri families including children, seniors, and people with diverse abilities. The House version of the bill, HB 217, was heard on March 1. Health Forward submitted testimony in opposition of this bill (and the Senate bill in January) which would place yet another strain on Missouri families during what is already a challenging and life-threatening time.


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