January 2021 legislative update

Health Forward is launching a monthly legislative update that will follow the important issues moving through legislative sessions in Kansas and Missouri. As we build upon our advocacy, we will always aim to keep partners informed of our work and the issues we are engaged in. We welcome the opportunity to collaborate with community partners that share similar interests. Reach out to us if there are opportunities to work together to strengthen our collective advocacy voice.

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Kansas

The first month of the legislative session in Kansas brought the introduction of several pieces of legislation related to Health Forward’s policy agenda. Gov. Laura Kelly began to move on her agenda, committing to many issues Health Forward cares about. State legislators acted on a number of bills that would impact the governor’s authority to respond to the needs of the pandemic, control the dissemination of COVID-19 vaccines throughout the state, and dictate reproductive rights.

State of the State address

Gov. Kelly previewed her agenda in her State of the State Address on Jan. 12, which largely focused on similar themes that have been a staple of her term. As expected, response to the pandemic and vaccination dissemination were at the center, as the state responds to the ongoing crisis. Her budget proposal does not call for any sales or income tax increases in light of the economic challenges. She re-committed herself to expanding Medicaid to the 165,000 Kansans that fall in the coverage gap. Gov. Kelly’s budget also includes more money for higher education, and expanded substance abuse treatment in correctional facilities.

Medicaid expansion

On Feb. 1, Gov. Kelly announced a plan to finance Medicaid expansion through legalizing medicinal marijuana. Health Forward is joined by many other health focused organizations, including the Alliance for a Healthy Kansas, in support of expanding access to health care for people without insurance. We commend Gov. Kelly for her continued leadership on health care access for the uninsured and urge the Kansas Legislature to act now to expand Medicaid and consider the governor’s proposal.

COVID-19 vaccine distribution

The House Health and Human Services Committee and the Senate Public Health and Welfare Committee jointly met twice in January to hear testimony from Kansas Department of Health and Environment Secretary Lee Norman on COVID-19 response and vaccine rollout. Secretary Norman presented on the governor’s five-phase vaccine rollout and informed everyone that the state is now moving into phase two, which covers all Kansans over age 65, first responders, grocery store workers, teachers, and people living in large congregated environments such as nursing homes and prisons. Health Forward is pleased that vaccinations are proceeding and is actively involved in efforts to ensure vaccine rollouts are inclusive, equitable, and as quick as safely possible

Infant and maternal health

Two similar bills regarding the study and investigation of maternal deaths in Kansas were introduced in the House (HB 2108) and Senate (SB 42). If passed, they would require the secretary of health and environment to establish an external review committee to review Black maternal death cases. Health Forward views these bills as an important step toward racial and health equity in Kansas. Racial disparities in maternal health are a byproduct of health inequities, and Health Forward is supportive of these bills.

Missouri

The first month of the legislative session in Missouri started slower than usual as COVID-19 outbreaks caused irregular schedules and legislators are quarantining after exposure. Gov. Mike Parson introduced his agenda and budget recommendations on Jan. 27, which reinforced his commitment to workforce development and infrastructure. Additionally, a number of bills that align with Health Forward’s policy agenda are beginning to move.

State of the State address and Medicaid expansion implementation

Gov. Parson delivered his State of the State address in the Senate chamber. Continuing on his priorities over the last year, his main focus remains jobs, bridges, and roads. Additionally, he emphasized a focus on children and the announcement of a new Office of Childhood, pulling together various state programs related to children under a single roof.

Gov. Parson’s notable fiscal year 2022 budget recommendations include fully funding the public school formula, realigning early childhood education, and funding six new mental health Crisis Stabilization Centers. The governor also discussed expanding Medicaid pursuant to the state constitution by allocating $1.9 billion in funding for the next fiscal year, of which $1.65 billion is set to come from federal funds.

The various budget and appropriations committees have begun meeting to review the governor’s recommendations.

COVID-19 vaccine distribution

Missouri is currently vaccinating up to Phase 1B, as vaccine distribution across the state has gotten a slow start. Missouri is in the lower quartile of states where populations have gotten at least one shot. As of Feb. 7, 7.8 percent of the population has gotten at least the first vaccine, and 2.3 percent of the population has gotten two doses.

Public health authority

Several public health authority bills were heard by the Health and Pensions Committee. Senators supporting the bills discussed their concerns that public health orders during COVID-19 have not properly considered economic impact, have impeded religious freedom and individual liberty, and have lacked a process for which they could be reviewed or appealed. Opponents focused on the important role local public health agencies play and fear that the bills would inhibit agencies’ ability to perform their daily functions. SB12 ultimately superseded the bills and includes provisions from other proposed legislation. It was passed out of committee last week and is not on the Senate floor calendar. The Missouri House voted out public health authority bills last week. Health Forward will be closely monitoring these bills, as we believe that it is critical to preserve local authorities’ ability to respond to public health crises in real time, but that local authority must be balanced by a state-wide perspective of needs and ancillary impact

Federal Reimbursement Allowances

The Senate Appropriations Committee met to hear SB1, which extends the Federal Reimbursement Allowances (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, and it has been placed on the Senate floor calendar. Debate could occur as early as this week.

Prescription drug monitoring program

Missouri remains the only state without a statewide prescription drug monitoring program (PDMP). SB 63 was heard last week in the Governmental Accountability and Fiscal Oversight Committee, and voted out of committee. Health Forward submitted testimony in support of the creation of a statewide PDMP and will continue to monitor this legislation.

Low-income housing tax credits

Legislation was introduced in the Missouri Senate that would limit the allocation of the state nine percent low-income housing tax credits (LIHTCs) to 70 percent of the federal LIHTC amount and cap the state four percent LIHTC allocation at $4 million annually. SB 85 is similar to legislation introduced in the past few sessions of the Missouri Legislature. Missouri funded the state LIHTC incentive in 2020 for the first time since 2017 and the Missouri Housing Development Commission limited the nine precent credits to 70 percent of the federal allocation and capped four percent credits at $3 million. Health Forward believes that the availability of quality, safe, and affordable housing is critical to positive health outcomes, and will be monitoring this legislation closely.

Supplemental Nutrition Assistance Program

Senate Bill 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. Health Forward submitted testimony in opposition of this bill, which would place yet another strain on Missouri families during what is already a challenging and life-threatening time.


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