What we’re watching: March 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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Kansas

The Kansas Legislature will soon be moving into their spring break, which is April 10 through May 2. They will come back to the capitol for veto session on May 3. 

Health Forward continues to meet with members of our service area delegation, leadership, and the administration to discuss our policy priorities and offer our support on health-related matters. Here is what we were following in March.

Medicaid expansion

Gov. Laura Kelly’s Medicaid expansion bill, SB 287, was referred to the Committee on Public Health and Welfare in early March. The bill was sponsored by the Committee on Federal and State Affairs. We commend Gov. Kelly for her continued leadership on health care access. 

The latest COVID-19 relief package gives the legislature another reason to expand Medicaid to 165,000 Kansans by providing additional funding from the federal government. The $450 million incentive would provide the ability to expand Medicaid in a budget-neutral way for the first two years, with 90 percent of costs covered thereafter.

The House deliberated its budget bill, HB 2397, which notably included a Medicaid expansion amendment led by Rep. Brett Parker, which failed 46-78. Senate Minority Leader Dinah Sykes also attempted to add a Medicaid expansion amendment to SB 238 in early March, which failed on a vote 12-23.  

Public health authority

Gov. Kelly signed SB 40 into law, which extended the State of Disaster Emergency and allowed the state to provide hospitals with PPE, support food banks and panties, and continue COVID-19 response. The bill also included problematic provisions that revoked all executive orders related to the pandemic and stripped appointed local health officers of their power to impose restrictions and left the decisions to the elected county commissioners. While she did not agree with some of the provisions she signed into law, Gov. Kelly expressed her commitment to working with legislators and local leaders to ensure the health and safety of Kansans across the state. 

COVID-19 Vaccine distribution

Vaccine distribution ramped up quickly with the addition of the Johnson & Johnson vaccine and increased availability of Moderna and Pfizer vaccines. Kansas is currently offering vaccines to all willing adults. 

As of April 2:

  • More than 1.3 million doses have been administered
  • 29.8 percent of the population has received at least one dose of the vaccine 
  • Approximately 455,000 Kansans have been fully vaccinated

Supplemental Nutrition Assistance Program (SNAP)

Health Forward, along with a coalition of more than 30 Kansas organizations led by Kansas Action for Children, advocated in support of HB 2371. The bill would have removed cooperation with child support from the requirements for food and child care assistance, and also exempt adults enrolled in school from the work requirement for child care assistance. Unfortunately, this was stricken from the calendar and will not be advancing. We hope to see more support for this type of legislation in the future. Participation in SNAP  should not be connected to the ability to pay child support. Cooperation requirements negatively impact financial stability and threaten children’s lives, as well as the well-being of custodial and non-custodial parents. 

Telehealth

The House Health Committee held a telehealth parity roundtable discussion in March, which addressed the future of telehealth and possible compromise for a primary telemedicine bill, HB 2206. Health care providers argued for payment parity for services provided via telehealth, given demand for virtual care continues to grow. Insurers do not believe more information is needed to make these policy decisions, given the unusual circumstances created by COVID-19. Health Forward believes that telehealth is a viable solution for health care, particularly for people without reliable modes of transportation or those who are unable to access traditional medical services. We will continue to monitor the progress of this bill.

Rural Emergency Hospital Act

The House passed SB 175, which combines two separate pieces of legislation. This bill now includes the language from the Rural Emergency Hospital Act (HB 2261) and the Rural Hospital Innovation Grant Program (HB 2174). The Rural Emergency Hospital Act would allow communities flexibility to utilize the Rural Emergency Hospital Model to preserve access to preventative and primary care across the state. iIt has been discussed for many years in Kansas, and would be a positive step toward improving access to health services in rural parts of the state. This bill would create a category of licensure to enable Kansas hospitals to receive federal health care reimbursement as rural emergency hospitals. The combined bill is now going through the conference committee process.

MISSOURI

Health Forward continues to meet with legislators from our service area to discuss our policy priorities, including Medicaid expansion implementation, and the need to standardize the collection of disaggregated public health data across the state. 

Missouri’s legislative spring break was March 15-19, but that did not mean it was an uneventful transition into the second half of the legislative session. The House passed its version of the budget, and the Senate continues to move somewhat slowly with only a few weeks left before they move away from Senate bills and begin working on House bills. Here is what Health Forward followed over the past month.

Medicaid expansion 

Medicaid expansion held much airtime in the House during budget discussions. Last week, the House passed a budget that didn’t fund expansion and sent it to the Senate for their consideration. The opportunity to restore funding for expansion is now in the hands of the Senate. We are committed to working with the legislature to ensure expansion is fully funded by the constitutionally mandated deadline of July 1, per the will of Missouri voters

COVID-19 Vaccine distribution

Missouri is currently vaccinating up to Phase 2, with the announcement by Gov. Mike Parson that the state will move to Phase 3 on April 9. This puts Missouri ahead of its scheduled distribution plan, with approximately 880,000 Missouri residents currently eligible to receive a vaccine. Phase 3 will open vaccine eligibility to all adults – an additional 1.1 million people. 

As of April 4:

  • 28 percent of the Missouri population has received at least one dose of the vaccine
  • More than 1,057,000 Missourians are fully vaccinated

Public health authority

Several public health authority bills are circulating this legislative session (HB 75, HB 1144, SB 12), which limit local health department control to make critical decisions during times of emergency. While we understand the importance of a holistic review and statewide response, we will advocate against constraining local public health departments’ ability to respond to crises. The COVID pandemic has highlighted the need for swift movement and flexibility in creating local solutions to public health challenges. 

The new substitute for HB 75 has moved to the Senate. The bill was heard and voted out on the same day in Senate Health and Pensions, and could be submitted to the Senate floor calendar soon. The House has committed to vote out HB 602 and HB 288, and there are several “religious freedom” bills that relate to emergency orders and religion that have been passed out of committee. 

Disaggregation of public health data

Health Forward worked with Senator Barbara Washington to draft language for SB 543, which was second read and referred to the Senate Health and Pensions Committee. The bill requires the Missouri Department of Health and Senior Services, 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
  • 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. We are pleased this bill was introduced, and advocate for its passage. 

Broadband

Digital equity is tied to broadband infrastructure and the ability for all people to access internet services regardless of where they live. This is a new area of focus for Health Forward, and we have been watching bills that have the ability to provide greater internet coverage. SB 108 would allow two or more municipalities to form a broadband infrastructure improvement district for the delivery of broadband internet service to the residents of such municipalities. The bill was heard with no opposition, and passed the Senate floor. It now moves to the House. 

Prescription Drug Monitoring Program (PDMP)

Missouri remains the only state without a statewide PDMP. SB 63 was perfected on the Senate floor then voted out of the Governmental Accountability and Fiscal Oversight Committee. Sen. Rehder’s bill needs one more vote on the Senate floor before heading to the House. Health Forward submitted testimony in support of the creation of this bill. 

Supplemental Nutrition Assistance Program (SNAP)

SB 138 modifies SNAP to impose lengthy disqualification periods on participants who do not meet work requirements. SNAP provides sustenance for many Missouri families including children, seniors, and people with diverse abilities. The House version of HB 217 was heard on March 1. Health Forward submitted testimony in opposition of this bill (and the Senate bill in January) which would place yet another strain on Missouri families during what is already a challenging and life-threatening time. The bill passed out of the Rules – Legislative Oversight Committee, but it has not been placed on the House floor calendar for debate. 

The House Agriculture Committee heard HB 594, which would extend a pilot program that allows SNAP participants to use their funds at farmers markets for fresh fruits and vegetables. Health Forward went on record in support of this bill, as we have in prior years. The bill is scheduled for a vote in early April. The Senate version of the bill was heard and voted out of the Senate Agriculture committee.


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