What we’re watching: April 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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The Kansas Legislature was on spring break for three weeks in April, which made for a quiet month. Health Forward continued meetings with legislators to discuss our policy priorities and find areas of alignment. They are back for “Veto Session” as of May 3. As there were not many hearings in April, our update on Kansas is on the lighter side. 

Medicaid Expansion

The Kansas Hospital Association, in conjunction with the Alliance for a Healthy Kansas, will release an updated version of the Leatherman Report on Economic Impact of Expansion. Kansas State University economist John Leatherman first issued the report in 2019 and updates will be released in early May. This report will supply updated data on the economic impact of Medicaid expansion on Kansas.

COVID-19 Vaccine Distribution

Kansas continues open vaccination without restrictions to all adults. As of May 5: 

  • More than 1.9 million doses of the vaccine have been administered
  • 38.8 percent of the population has received at least one dose of the vaccine
  • 950,000 Kansans have been fully vaccinated by both doses


We are nearing the end of the 2021 legislative session in Missouri with a few major topics left on the table, as well as a constitutional requirement to pass the budget by this Friday, May 7, at 6 p.m. Federal government continues to issue guidance on the COVID-19 funds flowing into states following the actual release of the dollars. In sum, Missouri is projected to receive $5.4 billion. Spending of the funds will not take place until further guidance is released and the state determines what to do with the influx of federal support. The legislature also plans to solicit feedback on how state infrastructure dollars should be spent to help inform the public health response. 

Medicaid Expansion 

Missouri made national headlines when the Legislature declined to include funding for Medicaid expansion in the fiscal year 2022 budget. After the House version failed early in April, the Senate took up the appropriations bill on April 28. While Sen. John Rizzo (District 11) attempted to restore funding for expansion to the budget through a floor amendment, the measure ultimately failed by a vote of 14-20. Republican Sens. Rowden, Hough, Brown, and Cierpiot joined Democratic senators and voted in favor of expansionHealth Forward, along with other advocates, remain hopeful that Gov. Parson will use his authority to implement expansion on July 1 — the deadline set by the constitutional amendment.The constitutional amendment sets the start of expanded enrollment for July 1, 2021. The looming uncertainty about funding complicates enrollment plans. Health Forward continues to support the timely implementation of Medicaid to extend coverage to the Missourians that fall into the coverage gap. 

COVID-19 Vaccine Distribution

Missouri is currently vaccinating all phases. This puts Missouri ahead of schedule with the vaccine roll-out plan, with all Missouri residents currently eligible to receive a vaccine. As of May 4: 

  • Approximately 38 percent of the population has received at least one dose of the vaccine
  • 1.8 million Missourians have been fully vaccinated by both doses

Public Health Authority

Several public health authority bills have been circulating this legislative session, some of which limit local health department control to make critical decisions during times of emergency. We strongly believe constraining the ability of local public health departments to respond to crisis is not in the best interest of public health. Numerous bills that include some language on limiting local authority (including HB 75, HB 602, HB 228, HB 1408, HB 1406 and HB 1407), have had varying degrees of movement this session. Most recently, language was added to HB 271 to limit local public health authority and will go to conference where the House and Senate will work out differences. Unfortunately, we do not anticipate that the public health provision will be changed or removed. 

Public Health Data

Health Forward worked with Senator Barbara Washington to draft language for SB 543, which was introduced in late February. 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 in Missouri, and a critical component of policymaking to address systemic injustices. The bill received a hearing on May 5 in the Senate Health and Pensions Committee, where our director of policy and strategic initiatives, McClain Bryant Macklin, offered supporting testimony. We expect it will go up for a vote sometime the week of May 10. While it is late in the 2021 session, we are pleased to be advocating for its passage. 

Prescription Drug Monitoring Program

Missouri remains the only state without a statewide prescription drug monitoring program. SB 63 was perfected on the Senate floor then voted out of the Governmental Accountability and Fiscal Oversight Committee. It continues to make progress as it moves through the second chamber, and received a hearing in House Rules Legislative Oversight Committee on May 5. Health Forward submitted testimony in support of the creation of a statewide prescription drug monitoring program, and remains hopeful that this will be the year it is adopted.

Supplemental Nutrition Assistance Program

The House Agriculture Committee heard HB 594, which would extend a pilot program that allows SNAP recipients to use their funds at local farmers markets for fresh fruits and vegetables. Health Forward went on record in support of this bill, as we have in prior years. The Senate version of the bill was heard and voted out of the Senate Agriculture committee, with no continued movement after that. As we near the close of session, advocates are looking for alternative vehicles for this language in order to extend this beneficial program past the pilot phase. 


While not on our current agenda, Health Forward has long supported policies that combat the harmful effects of tobacco use. We have been following SB 124, which was heard in the Senate Committee on Seniors, Families, Veterans & Military Affairs. The legislation contains several provisions, including raising Missouri’s tobacco age to 21 to align state law with federal law. The bill was voted out of committee without any amendments. HB 517 would also raise the legal age of purchasing tobacco to 21, but contains some concerning preemption language which we oppose. While the bill itself will not have time to pass this year, we will continue to watch for possible amendments adding the language to other bills.