What we’re watching: April 2022 legislative update in Kansas, Missouri

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Health Forward is supporting and building inclusive, powerful, and healthy communities by prioritizing people who experience the greatest injustices in health outcomes. We are working to remove those injustices through our leadership, advocacy, and resources. 

Our current Kansas and Missouri policy agendas outline the unique challenges that each state faces and seeks to address state-centric solutions within the following policy goals:

  1. Equitable access to high-quality health care.
  2. Increased funding for, and improved administration of public health infrastructure and resources.
  3. Addressing the social and political influencers of health that contribute to health injustices.

These goals overlap with our new purpose areas

In 2022 we will track relevant information in Kansas in Missouri and lend our voice to support policies that advance our purpose-driven work.

Kansas

The Kansas Legislature returned from break for its veto session on April 25.  The veto session is where the Legislature undertakes any overrides of bills vetoed by Gov. Laura Kelly. Legislators typically use the spring break to visit with and gain insight from their constituents on a variety of issues.

Some of the priority topics were the K-12 budget; legislation on the food sales tax reduction/elimination; and new electoral district maps redrawn after the 2020 Census. 

Although another legislative session has passed without action to expand Kansas’ Medicaid program, Health Forward will continue to join our partners in expansion advocacy in 2023.  

Here’s a look at where things stand as the Kansas Legislature wraps up regular business for this year’s session:

Medicaid Expansion

While the window for Medicaid expansion has likely closed for 2022, partners and advocates are not losing any momentum to get this crucial win for Kansans next year. 

On April 13, the Alliance for a Healthy Kansas hosted a public hearing to share information and stories on expanding KanCare. If you missed it, you can still watch the Facebook Live recording

The Kansas City Medical Society, in partnership with Health Forward, hosted a webinar and panel to train people on how to spread the word about expanding KanCare. You can watch a recording of that and other webinars on the Kansas City Medical Society website.

Throughout the remainder of the year, we will strategize  how we can bring this win to the 150,000 Kansans who cannot access quality health care.

 Redistricting

On April 25, a Wyandotte County judge struck down a congressional map that was adopted earlier this year by a veto override. The judge ruled that it was gerrymandered in a way that would dilute the votes of Kansans of color. The ruling is being appealed to the Kansas Supreme Court, but it is unclear how boundaries will end up for the 2022 midterm elections.

Sub SB563, the map that redraws state senate and house of representative districts, was adopted by the Legislature on March 30 and is awaiting signature or veto from Gov. Kelly. It cleared the House with 83 in favor and 40 opposed, and it cleared the Senate with 29 in favor and 11 opposed. The bill also contained a redrawn map of the state Board of Education, which some are also concerned is gerrymandered.

Health Forward supports equitable drawing of district lines to ensure that community voices are heard and have representation in elected offices.

Food Sales Tax

HB 2106 will gradually lower the food sales tax from 6.5 percent to zero by 2025. Late on April 28, the House approved the bill overwhelmingly, and the Senate unanimously. Gov. Kelly has promised to sign the legislation.

The reduction in the food sales tax won’t be felt until Jan. 1, 2023, when it drops to 4 percent then to 2 percent in 2024 and finally to zero in 2025. These annual decreases aren’t as immediate as some would’ve hoped; however, this “stair step” approach was rationalized as a moderate solution to ensure fiscal stability as the tax is phased out. 

Kansas has one of the highest food sales tax rates in the nation. Health Forward wholly supports eliminating the food sales tax, which is especially burdensome to Kansans paid lower wages.

 Mental Health

SB19, which creates a 988 suicide prevention and mental health crisis hotline, was passed by the House this week. The bill included immediate funding for the 988 hotline to begin operating as soon as it is signed into law by Gov. Kelly.

Health Forward submitted testimony in favor of the 988 suicide prevention and mental health crisis hotline bill. This new resource is a win for Kansans experiencing a mental health emergency.


Missouri

We’re keeping a close watch on a legislative attempt to put Missouri’s entire Medicaid program funding into the appropriations process on an annual basis. This could give the General Assembly the power to defund expansion and subject enrollees to work requirements. Work requirements are an unnecessary barrier to access and, in fact, most people eligible for Medicaid in Missouri under expansion are already working.

The Missouri Legislature has been working intently the past couple of weeks to pass the budget by the constitutionally provisioned deadline of May 6. The Senate has been busy this week, particularly on April 26 when 13 budget bills were passed. Absent from this action, however, is the bill that would appropriate federal relief dollars, which is still in committee. The regular session comes to a close on May 13 at 6 p.m., at which point all bills not passed in both houses die — unless Gov. Parson calls a special session.

Medicaid Expansion

  • HJR 117 was voted out of the Senate Appropriations Committee. Health Forward testified in opposition to this bill, which will ask Missouri voters to allow legislators to determine funding amounts for Medicaid program funding on an annual basis and impose work requirements on those eligible. It is currently in the Government Accountability and Fiscal Oversight (GAFO) committee and is expected to be considered by the full Senate during floor debate, though it’s unclear when that may happen.
  • There has been no recent action on HJR 92, which proposes an alteration to Medicaid expansion that opens the door to work requirements. Health Forward, along with Missouri Health Care for All, AARP, and Mid-Missouri Fellowship of Reconciliation went on record in opposition to this proposed constitutional amendment.
  • SB 935 would ease barriers to accessing MO HealthNet. Specifically, it would end the cumbersome governmental process of re-verification and 10-day deadline for recipient response time. Children who are eligible for MO HealthNet remain eligible for 12 months subsequent to the last month in which the child was enrolled. It would also end the 30-day waiting period for enrollment into the Children’s Health Insurance Program for families living on an income of more than 225 percent of the federal poverty level. It has passed out of the Senate Seniors, Families, Veterans and Military Affairs Committee, but is not on any calendar as of this blog post publication.

Health Forward submitted testimony in opposition to HJR 117, which subverts the voice of Missouri voters and jeopardizes efforts to provide working Missourians with access to quality, affordable health care. We oppose any efforts to impose work requirements because they restrict access to health care by adding another layer of administrative overhead. We’re also opposed to work requirements as they are rooted in anti-Blackness established during the Jim Crow era.

Redistricting

There has not been much movement on redistricting in the Legislature as their work has been focused on passing the budget. It appears that it is still at a stalemate with no workable solution on the horizon.

Voting Rights and Initiative Petitions 

The deadline for bills to advance out of both houses is approaching. These are key pieces that legislators might focus on during the last two weeks of session:

  • HJR 79 would require a two-thirds supermajority approval threshold for any Missouri constitutional amendment. It has passed out of the House and was voted out of its Senate committee last week. It recently passed out of the GAFO committee and is eligible for debate and passage through the Senate. If passed it would be on the ballot for this year’s election cycle. 
    • We’re also keeping an eye on HJR 91, which would also raise the threshold of passage for amendments to two-thirds majority rather than the current simple majority (more than 50 percent).
  • HB 1878 would make it more difficult to vote absentee by using overly restrictive identity verification, as well as prohibit outside entities to help cover funding gaps for under-resourced election authorities. The bill was passed out of the Senate this week, and goes back to the House for an up-or-down vote or to go to conference with the Senate. 
    • A small bright spot in this bill was that an amendment was added to allow anyone to vote absentee in person two weeks before an election without any excuse needed. This doesn’t change our opposition to the overall bill.

Health Forward supports the drawing of congressional maps that provide for fair representation for all Missourians. Additionally, we are in favor of preserving and promoting elections and initiatives that allow for addressing policy concerns through a fair and democratic process.

Food Policy

Some innovative policies around food and nutritional assistance have been proposed this session. At the same time, others have proposed restrictions on these safety net programs that would harm Missourians.

  • SB 798 would allow older adults and people with diverse abilities  to use their Supplemental Nutrition Assistance Program (SNAP) benefits in restaurants. This innovative bill has passed out of the Senate without any added language involving work requirements. However, it’s unclear how this bill will proceed in the House.
  • A trifecta of bad bills (HB 2085, HB 2156, HB 2255) has been placed on the House debate calendar. These will add limits to accessing cash from an ATM for Temporary Assistance Program participants and work requirements for SNAP participants, which would make navigating these programs nearly impossible for working families, especially single-parent homes.

Telehealth 

HB 2510 would allow doctors licensed in other states to see Missouri patients, expanding access for Missourians. It was discussed in committee with the MO Nurses Association, Blue Cross Blue Shield of Kansas City, Opportunity Solutions Project, and Cicero Action testifying in support. This legislation was voted out of committee and has yet to be taken up on the House floor. 

We push for policies that create equitable and just places that foster health and economic advancement and, as such, are in opposition to work requirements.

Broadband Access

The House has been active on the issue of increasing broadband access in urban and rural areas of the state. As it stands, there is an “omnibus” (including a variety of things) broadband bill (HB 2638) that passed out of the House with a large majority. It has moved over to the Senate, though it will have to compete for floor time, given the volume of bills and short time remaining in session.

Health Forward provided testimony earlier in the 2022 in support of HB 2675 to help rural and urban residents in our communities gain access to affordable, high-speed internet. The Legislature should take some basic action on broadband this session to set the table for more substantive and helpful policy in the 2023 session.

Housing

Both the House (HB 2614) and Senate (SB 1106) heard bills regarding requirements for housing program funding, especially those that apply to Missourians who do not have housing. The House bill is currently on the calendar for consideration and the Senate bill was passed out of committee. These bills are problematic and invasive for people in a housing crisis and would make it exceedingly difficult for organizations to access critical state funding and help folks in need of shelter.

We are opposed to both of these pieces of legislation. They erect unnecessary barriers for people attempting to find safe living spaces or eventually find affordable permanent housing.