Policy and advocacy

An end-of-session legislative update from Health Forward Foundation

June 2024

We’ve arrived at the end of both regular sessions in Kansas and Missouri. The overall story of the year is that the policy landscape is shifting quickly in some directions but remaining locked in others.

Kansas’ legislative session saw another year without the expansion of Medicaid. However, the legislature moved quickly to adopt untested and economically harmful anti-diversity, equity, and inclusion legislation.

In Missouri, we saw more gridlock than fast-moving policy, but the Federal Reimbursement Allowance was adopted just in the nick of time. And because of diligent work by the pro-majority rule coalition, attempts to weaken the initiative petition process petered out.

With our partners playing an essential leading role, we had some pretty good wins this year, marked by some areas where we’ll work to change or improve in upcoming sessions.

Check out our policy agendas for Kansas and Missouri to get a sense of how it all shook out this year relative to purpose plan.

Kansas

HB 2105, an anti-DEI bill that applies to higher education, was passed before the legislature went on their April break. Gov. Kelly let the bill become law without her signature. Kansas now joins eight other states who’ve adopted these problematic laws across the country in 2024. We will continue to push against this legislation moving forward and at every possible opportunity.
The 2024 session elapsed with Medicaid expansion not taken up yet again. Even though the momentum was strong this year, there was just not enough to overcome the obstacles in both chambers. As we have said in years previous, us and partners across Kansas aren’t deterred or discouraged. In 2025, we’ll refocus and come back again with expansion as our number one priority in the state.
A special legislative session is scheduled to kick off on June 18. The main point of contention is a tax package, with Gov. Kelly having vetoed two bills this year sent to her by the legislature.

People policy goal: People can easily access safe, quality, and affordable whole—person care.

Policy issue and relevant legislation	What it does	Status	Our stance
Medicaid Expansion (SB 355 and HB 2556)	Expands Medicaid in Kansas, one of only 10 states refusing to expand the program, to provide health insurance to nearly 150,000 Kansans	Despite huge support during the March 20th hearings, both bills are dead and unlikely to be addressed in a special session.	We supported the expansion of Medicaid in Kansas and will continue to advocate for its adoption until it happens.
Removing authority of public health officials (SB 6, SB 390, and SB 391)	These bills generally remove the authority of statewide public health officials to do their job: prevent the spread of infectious diseases.	SB 6 passed the Senate last year 22-18 and is in the House. SB 391 was adopted in the Senate on February 22nd this year, 23-17 but wasn’t taken up by the House so it is dead.	We opposed all these bills. They would actively harm public health, especially in infectious disease outbreaks.
Improving maternal health outcomes (SB 118)	Would expand authority to allow for a formal review of maternal deaths, akin to Missouri’s PAMR.	This bill died in committee with the end of the session.	We supported this legislation and would encourage a better definition of disaggregated data to specify at least by race, ethnicity, language, and geography.
Expanding telemedicine (HB 2337 and SB 246)	Expands telehealth offerings and requires certain coverage under insurance.	Both of these bills died in committee with the end of the session.	We supported this legislation.
Audits for safety net programs (SB 488)	Allows the inspector general to conduct audits on all state cash, food, and health safety net programs.	Passed out of the Senate 22-18 on March 26th, but died in committee on the House side.	While Health Forward is not opposed to audits of programs, we fear this would empower the use of burdensome audits and, ultimately, unnecessary barriers for hard working people to access the safety net.

Power policy goal: Participation in our democracy and policymaking process improves health outcomes.

Policy issue and relevant legislation	What they do	Status	Our stance
Restricting advance mail in ballot voting (HB 2512, HB 2513, HB 2571, SB 14, SB 343, SB 365, and SB 366)	Generally, these bills all focus on making advance mail in ballot voting more difficult. HB 2513 and SB 365 require return by 7pm on election day. HB 2571 categorizes mail in ballots as provisional until verified by election officials. SBs 343 and 366 restrict how ballots are sent out by election officials.	Fortunately, none of these bills passed and all have expired with the end of session.	We opposed all these bills as they all make it more difficult to vote in advance, vote by mail in ballot, or to access them in the first place. We provided written testimony in opposition to HB 2512, HB 2571, and SB 366.

Place policy goal: Our communities are healthy place where people fully participate in the digital economy and build wealth through safe, quality, and affordable housing and homeownership.

Policy issue and relevant legislation	What it does	Status	Our stance
Extending the Homestead Property Tax refund to renters (HB 2636).	Allows renters to qualify for up to $700 in a refundable tax credit, which can be put towards the cost of renting.	This bill was heard on February 15th, 2024 but didn’t advance and has died with the end of session.	We supported this legislation and provided written testimony to the committee.
Prohibiting localities from imposing fees or registration requirements on vacant properties (HB 2083)	Limits what local governments can do to help fill vacant housing.	Passed the House in 2023 and was amended by the Senate but has now died after not receiving final approval.	We are generally opposed to legislation that preempts localities from doing what they deem necessary, in this case, to induce owners of vacant properties to have them occupied. With the current housing shortage, we need more, not less, housing.
Local ad valorem tax reduction fund (LAVTRF) changes (SB 332)	The Governor’s budget proposal includes the LAVTRF, which gives dollars back to counties and cities to use in certain circumstances, including lowering property taxes. SB 332 would have the LAVTRF be used to issue rebates to residential property owners.	This bill died in committee with the end of the legislative session.	Generally, we are supportive of measures that would reduce property taxes for homeowners, especially for seniors and those who may be priced out by property tax increases.
Housing incentive districts and credit transferability (SB 34)	Allows for the designation of urban and rural housing incentive districts to spur the creation of more affordable housing and increase the transferability of tax credits related to housing development.	This legislation expired in the House with the close of the session.	Not specific to this legislation, we are in favor of measures that could lead to more affordable housing stock. However, there needs to be more systemic investment from the state.

Platform policy goal: Community health is influenced by systems, policies, and stories that promote racial equity and economic inclusion.

Policy issue and relevant legislation	What it does	Status	Our stance
Anti-diversity, equity, and inclusion (DEI) in hiring practices and statements in higher education (HB 2460 and HB 2105)	Would ban universities from considering potential student or faculty stance regarding their viewpoint about diversity, equity, and inclusion.	While 2460 passed the House 81-39 on March 21st, 2105 ended up being the vehicle for the bill passing both chambers. The governor allowed it to become law without signature on April 25th.	We opposed this this, and all anti-DEI legislation, which harms our education pathways – especially for health sciences professions – and economy. We testified in opposition in person.
Prohibition on people from certain countries from owning real property in Kansas (House sub for SB 172)	Bans people from 6 countries from owning real property in Kansas, unless approved by an oversight board.	This legislation was passed on April 30th as the session came to a close and the Governor vetoed it on the same day. There is a slight chance it could be taken up during the special session.	We understand the intent behind the bill but opposed it due to the negative impacts on immigrants from these countries awaiting legal status in the US, harming their ability to own or start businesses in the state.
Protecting hair styles from discrimination in the workplace – the ‘CROWN Act’ (HB 2044 and SB 36)	These bills would make it unlawful to discriminate against someone based on their hairstyle typically associated with race, including braids, locs, and twists. It would ensure that people with afro—textured hair are not discriminated against based on their choice of hair style.	These bills have expired in their respective committees with the legislative session coming to a close.	Health Forward supported these bills as currently written, and submitted testimony in support on SB 36. It ensures that people wearing natural or protective hair styles do not face discrimination, which disproportionately impacts Black women in the workplace. It aligns with our stance that racial equity should be pursued in all policies.

These highlighted bills are ones we are keeping a focus on, but to see a full list of the bills we’re tracking in Kansas.

Missouri

One of the most significant bills to thread its way through the Senate this year was the Federal Reimbursement Allowance (FRA) renewal — SB 748. Not only will this help to fund Missouri’s Medicaid program, but the bill also has a 5 year renewal window, meaning it won’t be taken up again until the 2029 session.
SJR 74 — which would dissolve simple majority rule for passing ballot initiatives, has died after an over 50-hour filibuster by the pro-majority rule coalition in the Senate. While this is good news — especially since reproductive rights and paid family leave are likely to be on the ballot this year — preserving the initiative petition is a key priority for Health Forward and we will remain vigilant in next year’s session for continued attempts to weaken it.
However, in some unfortunate news, SJR 78 passed both Houses and it seeks to ban ranked choice voting, as well as including misleading language on banning voting of non-citizens — something already prohibited in Missouri law.
It’s important to note that the General Assembly passed a record low number of bills (not counting the budget). There were many bills that would’ve advanced Health Forward’s purpose plan and been highly impactful for the state but weren’t taken up due to the logjams in the Senate. We factor this into our strategies as we gear up for each session and 2025 will be no different.

People policy goal: People can easily access safe, quality, and affordable whole—person care.

Policy issue and relevant legislation	What it does	Status	Our stance
Renewing the federal reimbursement allowance (FRA) aka the ‘provider tax’ (SB 748)	Allows Missouri to bring back billions in federal matching dollars to fund our Medicaid program.	This was passed on May 15th and will be signed by the Governor.	We supported this bill and provided testimony in favor.
Work requirements for Medicaid (SJR 76)	Would require people on Medicaid between ages 19 – 49 to submit to onerous work verification requirements to be eligible for health insurance.	It passed out of the Senate Health and Welfare Committee on March 27th but is dead with the close of the session.	We opposed this bill and any bill that imposes work requirements for access to safety net supports.
Data disaggregation by race, ethnicity, language, and geography for certain public health data (SBs 1239, 888, and 1357).	SB 1239 would require data disaggregation for certain demographic variables across a broad set of public health data. SBs 888 and 1357 are very similar but would apply to the pregnancy associated mortality review board (PAMR)	SBs 888 and 1357 have been combined and passed out of committee on February 28th but subsequently died on the end of session.	We supported all of these bills as written. We testified in support of SB 888 during its hearing on Jan. 24th.
Allowing for audio and audiovisual services to be considered telehealth (SB 931, also HBs 1421, 1873, and 1907)	These bills will allow audio-only and audiovisual communication to qualify as telehealth services, greatly expanding telehealth options.	All three of the bills on the House side passed out of their committee, in addition to the Senate bill on March 13th but they are expired with the end of session.	We supported the expansion of telehealth to include these options to be available to people needing remote care.
Expanding the coverage of doula services through Medicaid (HBs 1446 and 2632)	These bills would allow anyone covered on Medicaid who is expecting to give birth to have access to doula services.	Both of these bills passed out of committee, but died with the close of session.	We supported these bills and provided testimony in support.

Power policy goal: Participation in our democracy and policymaking process improves health outcomes.

Policy issue and relevant legislation	What it does	Status	Our stance
Modifying the initiative petition process – (SJR 49, 51, 56, 61, 73, 74, 77, 79, 81, 83, and HJRs 76 and 86 plus HB 1749)	These bills, numerous as they are, generally all make it more difficult to put questions to the citizen’s vote, more difficult to pass, and tweaks how those amendments can be changed.	SJR 74 was the main vehicle and though conflicting versions passed each chamber, they were not resolved. This resolution and all the others died at the end of session.	We oppose changes to the initiative petition process. We congratulate all of our partners in their diligent, hard work in killing these bills!
Adding an expiration date to voter registration and auto-rejecting absentee ballots without matching signatures (HB 2052)	As the description indicates, it would lead to disenfranchisement of people through not fault of their own and auto-rejection of an absentee ballot makes it more difficult to feel secure in your vote counting.	This bill died with the end of session.	We opposed this legislation and similar legislation that works to disenfranchise voters through unneeded barriers and obstacles.

Place policy goal: Our communities are healthy place where people fully participate in the digital economy and build wealth through safe, quality, and affordable housing and homeownership.

Policy issue and relevant legislation	What it does	Status	Our stance
Preempting local governments on requiring landlords to take housing assistance (HB 2385)	Prohibits local governments from requiring landlords from taking any federal housing assistance.	This bill died without being taken up by the Senate.	We strongly opposed this legislation as it would’ve made it more difficult to secure safe, affordable, and quality housing for people earning a low wage. We testified in opposition.
Broadband legislation – there is legislation to allow an income tax deduction for broadband internet expansion grants (HB 2142) and the establishment of a Broadband Development Council (HB 1813)	See brief descriptions in the Policy Issue column.	Both of these bills died at the close of the session.	We testified in support of HB 2142 because it would’ve provided a deduction only of those dollars are going to the express purpose of broadband internet access.
Preemption from the state on eviction moratoria (HB 2062)	HB 2062 prevents localities from having a moratorium on evictions, which was extremely important during the COVID outbreak.	HB 2062 was ‘truly agreed and finally passed’ on May 16th and is likely to be signed by the Governor.	We testified in opposition to HB 2062 on Jan. 17th.

Platform policy goal: Community health is influenced by systems, policies, and stories that promote racial equity and economic inclusion.

Policy issue and relevant legislation	What it does	Status	Our stance
Anti-diversity, equity and inclusion legislation – SB 1314, HB 2619, HB 2567, and SB 980.	HB 2619 (combines HBs 2365, 2448, and 2569) prohibits the state from spending dollars on diversity, equity, and inclusion initiatives. HB 2567 is a ‘Do No Harm’ bill that would restrict DEI funding specifically in medical sciences education. SB 980 regulates businesses with diversity, equity, and inclusion initiatives from contracting with the state.	HB 2619 and the remaining bills died with the end of session. HB 2619 though came the closest to full adoption, as it was passed by the House in very quick fashion but wasn’t taken up by the Senate.	We staunchly opposed these and all anti-DEI legislation as it cuts directly against our purpose of strengthening and building inclusive, powerful, and healthy communities characterized by racial equity and economic justice. We testified in opposition to HB 2619 and HB 2567 on February 13th.

These bills highlighted are ones we are keeping a focus on, but here is a full list of the bills we’re tracking in Missouri.

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An end-of-session legislative update from Health Forward Foundation

Kansas

Missouri

Purpose Areas

More About Our Work

Purpose Areas

More About Our Work

An end-of-session legislative update from Health Forward Foundation

Kansas

Missouri

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