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

Health Forward Foundation 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 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 easily overlap with our newly announced People, Power, and Place purpose areas and Platform strategies.

In 2022, we will track relevant legislation in Kansas and Missouri and lend our voice to support policies that advance our purpose-driven work. This includes working with our national representatives to do the same.

KANSAS

The legislative session began on Jan. 12 and will continue previous years’ attempts to respond to the pandemic and its ancillary effects. 

Like legislatures around the country, the Kansas Legislature will also focus much of its early attention on redrawing electoral district lines in response to the 2020 Census. Several bills have already been filed this session proposing election reforms and changes to state tax policy. The Legislature and Gov. Laura Kelly will continue to explore paths forward for Medicaid expansion. 

Here is what we will be following in Kansas:

State of the State

Governor Kelly provided her State of the State address January 12th, laying out her priorities for this year. She reiterated her commitment to Medicaid expansion, pandemic recovery, and fiscal responsibility. Gov. Kelly also proposed a freeze on college tuition to provide relief to students, and financial support for Kansas law enforcement. In the last year of her first term, Gov. Kelly will focus on spending federal pandemic relief dollars while seeking bipartisan support for other priorities in her agenda as she prepares to run for a second term.

Medicaid expansion 

On Jan. 6, Kansas House Democrats proposed a state constitutional amendment to expand Medicaid. The measure will require a two-thirds vote of the Legislature to pass. If passed, the measure will go to a public vote in November 2022. Kansas is one of 12 states yet to expand Medicaid. Advocates are awaiting if Gov. Kelly will also introduce legislation to expand Medicaid. Medicaid expansion remains Health Forward’s top issue in Kansas. 

We will continue to support efforts to expand Medicaid for all Kansans who cannot afford quality health care.

Redistricting

Senate Bill 355, which proposes redrawing Kansas’ congressional districts, passed out of both legislative chambers, and awaits Gov. Kelly’s signature. The bill would split Wyandotte County into two congressional districts along I-70 Historically, all Wyandotte County has been in one congressional district. The Kansas Fair Count Coalition and other watchdog organizations have described the bill as gerrymandering that dilutes minority voting power and representation in Wyandotte County. Gov. Kelly is expected to veto the bill. It’s probable that the Legislature will overturn the veto, but nothing is certain. 

Health Forward supports equitable drawing of district lines to ensure minority populations, and populations with similar characteristics, have representation in elected offices.

Voting Rights

Several bills were introduced the last full week of January to modify voting rights and elections in Kansas. The bills address voting rights from a variety of directions, including:

  • Prohibiting the modification of election laws by agreement except as approved by the Legislative Coordinating Council (SB 418)
  • Requiring all advanced voting ballots be returned by 7 p.m. on Election Day (SB 394)
  • Requiring the Secretary of State and county election officers to develop a ballot system displaying the number of years an incumbent has served in the office (SB 391)
  • Requiring the secretary of state and local election officers to develop and require election workers to sign an affidavit  regarding proper handling of completed ballots (SB 390)
  • Requiring all voting systems for elections to use individual, voter-verified paper ballots that have a distinctive watermark (SB 389)
  • Requiring the use of the United States Postal Service when returning an advance ballot by mail (SB 388)
  • Requiring county election officers to provide precinct-level election results in machine-readable format within 30 days of any final canvas (HB2565)
  • Requiring a county election officer to send a confirmation of address when there is no election-related activity for any four-year period (HB2555)

Health Forward will monitor these bills, as power building and power sharing requires that Kansans have access to the electoral process and a voice in policymaking.

Food Sales Tax

Several bills have been introduced in both chambers to eliminate the food sales tax. Advocates, including Gov. Kelly and a coalition of organizations, led by Health Forward’s partner Kansas Action for Children, propose that the tax is no longer necessary given the state’s $2.9 billion budget surplus. The tax elimination would make stores on the Kansas side of the state line more competitive and benefit Kansans who face financial barriers to purchasing healthy foods. 

Opponents prefer a consumption tax over taxes on income and wealth and raised concerns about the impact of eliminating the food sales tax on state retail sales revenue. HB2484 and HB2487 and Senate bills 339 and 342 have received committee hearings and were positively received. 

Health Forward submitted testimony in favor of these bills and the elimination of the food sales tax, and will continue to monitor them as they advance through the legislative process.

Broadband internet access

During telecommunications presentations to the House Energy, Utilities, and Telecommunications Committee, speakers noted that landlines are still necessary in rural Kansas, the demand for data use has grown significantly, telecommunications jobs are growing, and broadband access has expanded but still has room to grow. Speakers also noted the need to consider where broadband will be adopted when rolling out state and federal subsidies for broadband. 

Health Forward is paying close attention to state broadband policy, as the provision of public health through telehealth is growing in use and broadband access and digital equity is necessary for all Kansans to access virtual health care services.


MISSOURI

Missouri’s legislative session began on Jan. 5. Lawmakers will have a tight timeline to adopt new legislative maps, allocate supplemental funds from the American Rescue Plan, and allocate funds for MO HealthNet. 

High-priority issues have rolled over from 2021 into 2022. Hearings in January focused on addressing charter school equity funding, redistricting, reproductive health issues, abortion access, election reform, and changes to the ballot initiative process. 

Here is what Health Forward was following over the past month:

State of the State

On Jan. 19, Gov. Mike Parson delivered the Missouri State of the State address, unveiling a $47.3 billion fiscal year 2023 state budget. Gov. Parson highlighted the state’s response to the ongoing pandemic, pushed early supplemental requests like the pay increase for state employees, and introduced his budget recommendations. Missouri will enter the new fiscal year with a surplus of $3 billion in general revenue, largely driven by the influx of federal funds. During the speech, Gov. Parson announced his recommendation to invest $400 million for broadband internet access, $722 million for child care, $28.5 million to establish a new 988 mental health crisis hotline, and $400 million of federal funds for the state’s pandemic response.

Medicaid Expansion

Also in January, the Missouri House Budget Committee heard a bill sponsored by the committee’s chair, Rep. Cody Smith, that would allow the General Assembly to limit the population eligible to receive MO HealthNet benefits via appropriation. HJR 117 proposes a constitutional amendment relating to MO HealthNet. If approved by a statewide vote, the bill would implement work requirements for MO HealthNet beneficiaries within the ages of 19–64 and would prohibit reimbursement with limited exceptions for services provided to patients from out-of-state. These proposed requirements could put Missouri at odds with federal regulations, which prohibit work requirements. 

Under this legislation, the Missouri General Assembly would have the authority to appropriate dollars for Medicaid based on population. A population would not be eligible to receive coverage if the General Assembly did not specifically make an appropriation for them even if they would otherwise meet the criteria outlined in the Medicaid expansion constitutional amendment. This is in direct response to the recent court ruling that required the state to fund the expansion of Mo HealthNet. 

The budget committee took testimony on the early supplemental bill (HB 3014) that includes Medicaid Expansion funding, the K-12 American Rescue Plan dollars that need to be expended by March, and money for the state’s employee pay plan. While the hearing lasted several hours, the Medicaid portion of the conversation moved quickly, with questions being more technical than combative. The bill is expected to be up for a vote in committee the first week of February. 

Health Forward remains closely engaged with efforts to ensure funding for Medicaid expansion as part of the overall Medicaid program, and to enroll newly eligible Missourians into the Medicaid program.

Vaccine mandates

The Missouri House heard 19 bills related to COVID-19 vaccines in January. More than 30 such bills have been introduced this session. The slate of bills included provisions that would prohibit entities from requiring COVID-19 vaccinations or proof of COVID-19 vaccination as a condition of employment or access. A few of the bills included provisions that extend beyond COVID-19 to address vaccination requirements in general and public health orders. Many business associations have advocated for the right to make decisions on whether to require vaccinations for themselves.  Debates over these bills will roll into February and will likely result in a consolidated bill on this issue.

Health Forward supports efforts to keep Missourians healthy and safe, including our workforce and children.

Redistricting

Both the Missouri Senate and House have been considering maps to redraw the lines of Missouri’s congressional districts. Currently on the table are a “6R-2D” map (six Republican districts and two Democratic districts) and a “7R-1D” (seven Republican districts and one Democratic district) map, the latter of which is supported by the Senate Conservative Caucus and would significantly alter how the Kansas City area is split up. The senate adjourned the last week of January without any resolution. The debates will carry over into at least the first part of February. 

Health Forward supports district lines that are drawn to accurately represent the people living within them, and will continue to monitor redistricting with an eye toward fair representation.

Voting rights

Several bills were introduced that would modify the process for: 1.) adding an initiative petition to the ballot; 2.) proposing constitutional amendments; or 3.) either the ballot initiative or constitutional amendment to ultimately take effect. 

These bills are viewed as direct responses to the expansion of Medicaid and as attempts to make ballot initiatives and constitutional amendments more difficult. 

Health Forward supports power sharing with the communities we serve, and power is often exercised in policymaking. Health Forward opposes any unreasonable restrictions on the initiative petition process or the ability of voting citizens to otherwise effect change in their communities. We will be closely monitoring these bills.

Broadband internet access

House Bill 2052, sponsored by Rep. Louis Riggs, would establish the 21st Century Broadband Development Task Force. 

The task force would evaluate the status of broadband internet access across the state and to make recommendations on how to increase access to high-speed, affordable broadband for Missourians. Additionally, the task force would support efforts to expand broadband services with federal funding, which must be appropriated by 2024 for initiatives implemented by 2026. 

The committee heard supporting testimony from utilities, cities, telecommunications companies, business groups, and the medical community – all interested in better telehealth, education, and work outcomes. 

Health Forward is working with our government affairs consultants to include a representative from our service area, who can advocate for digital equity and telehealth access, on the task force.


FEDERAL

On Jan. 7, Health Forward participated in a press event with Rep. Sharice Davids in support of the implementation of the No Surprise Billing Act, which prohibits surprise medical bills for emergency and other unanticipated out-of-network services. 

Health Forward supports the No Surprise Billing Act, as surprise medical bills are a major contributor to debt and place a financial burden on many individuals in our service area and inhibit economic opportunities and mobility.


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