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

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 and Missouri and lend our voice to support policies that advance our purpose-driven work.

Kansas

The regular session and first adjournment happened on April 1. Legislators will spend the next three weeks in their districts and will return April 25 to consider veto overrides and other items not passed in the regular session, such as food sales tax and the K-12 budget.

The Legislature has been largely consumed with the process of redrawing electoral district lines following the 2020 Census. Additionally, the push for Medicaid expansion seems to have stalled, while some other policies that restrict voting rights, taxes, and housing have seen some movement.

Here’s a quick rundown of what’s been happening over the past several weeks:

Medicaid Expansion

On March 16, the Senate adopted a budget that stripped out dollars set aside for a potential expansion of KanCare. The House undertook their appropriations bill on March 23, which passed 73-49. Of note was an amendment offered during floor debate to fund KanCare expansion, but which was rejected. These two bills are currently in Conference Committee to send a final budget to Gov. Laura Kelly.

Two Medicaid expansion advocates are hosting upcoming events about KanCare:

• Alliance for a Healthy Kansas will hold a public hearing on April 13 to share information on expanding Medicaid.
• Kansas City Medical Society is hosting an April 21 program that will prepare people to confidently talk about KanCare. 

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

Redistricting

On March 30, the Legislature adopted new maps for Kansas Senate and House boundaries in one bill — Sub SB563. It cleared the House with 83 in favor and 40 opposed and the Senate, with 29 in favor and 11 opposed. It heads to Gov. Kelly’s desk for signature.The bill also contained a redrawn map of the state Board of Education, which some have labeled as gerrymandered. Congressional maps are currently in court in Wyandotte County and will likely be decided this month.

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

Voting Rights

The Senate passed a bill that would shorten the time period in which advance voting ballots can be returned and would also limit the use of remote ballot boxes to return those ballots. In addition, it would reduce the amount of time for voter registration, decrease the number of drop boxes in use, and eliminate the three-day voter protection period for mail-in ballots. While the Conference Committee bill passed out of the Senate, it did not get a vote in the House. 

A pair of bills — SB 439 and HB 2555 — are in the House Elections Committee and both would require a county election officer to send a “confirmation of address” notice to a voter if they haven’t participated in any elections activity for four years. If the person doesn’t respond, they will have to re-register to vote. SB 439 passed out of the Senate, but it did not get a vote in the House.

Health Forward is monitoring these bills since they have the potential to limit community power by restricting Kansans’ ability to engage in the electoral process and by excluding community voices in policymaking.

Food as Medicine (Food Sales Tax)

The move to reduce or eliminate the food sales tax has hit some headwinds and the Legislature failed to eliminate or reduce the food sales tax before going on April break.

There is still a viable bill (HB 2711) that has passed out of the House Taxation Committee and would reduce the overall sales tax from 6.5 to 6.3 percent and the food sales tax from 6.5 to 3.5 percent. Additionally, it would provide a refundable food sales tax credit in 2023, which would help working Kansans significantly come tax time.

Health Forward has previously submitted testimony in favor of eliminating the food sales tax in Kansas. We will continue to advocate for an elimination or reduction of inequitable and regressive taxes on food.

Mental Health

SB19, which implements a 988 suicide prevention and mental health crisis hotline, has been sent to Conference Committee. Unfortunately, this bill did not get a vote as the regular session came to a close.

A bill that expands funding for newborn screening services passed out of the Senate unanimously on March 23 and has been referred to the House Committee on Health and Human Services for consideration. This bill didn’t receive a floor vote in the legislature before the regular session closed.

Affordable Housing

The Senate Federal and State Affairs Committee passed SB 376 out of committee, which would generate more resources for the building of residential homes and more dollars for rural and urban communities for affordable housing. This has not yet had any floor debate in the Senate and is unclear whether it will before session’s end.

The same committee also had a hearing on SB 369 which would create an affordable housing tax credit, similar to the federal Low Income Housing Tax Credit, for qualified projects in Kansas.

Health Forward submitted testimony in favor of the 988 suicide prevention and mental health crisis hotline bill. We also testified in support of SB 369 to establish an affordable housing tax credit program in Kansas. We will continue to monitor and advocate for other legislation that helps promote inclusive, powerful, and healthy communities.

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Missouri

Our biggest focus has been on the passage of House Joint Resolution 117. If approved, this resolution would put a question to voters this fall about placing Missouri’s entire Medicaid program funding into the appropriations process on an annual basis, which could give the General Assembly the power to defund expansion and subject enrollees to work requirements. This comes in addition to a string of restrictive voting rights bills and tension over new congressional district maps. These bills will come to a vote in the weeks ahead. The budget is expected to pass before the end of the legislative session.

Medicaid Expansion

• HJR 117 ​​was approved by the House and has now moved over to the Senate for consideration. It was heard in the Senate Appropriations Committee with Health Forward testifying in opposition. A committee vote is expected in the near future and the resolution will next be considered by the full Senate during floor debate.
• HJR 92 proposes an alteration to Medicaid expansion which could open 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 access to MO HealthNet, Missouri’s Medicaid program. Specifically, it would end the need to send re-verification and receive a response within 10 days. 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.

Health Forward submitted testimony in opposition to HJR 117 and HJR 92, 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.

Redistricting

Thus far, redrawing the congressional maps in Missouri remains at a stalemate. Since there are only about six weeks left in the legislative session, this has the potential to consume the focus of the General Assembly.

Voting Rights and Initiative Petitions 

The General Assembly has been especially active in the introduction of bills and joint resolutions that would impact Missourians’ ability to participate in democracy in a way that promotes their voice and values. Here is a selection of bills and resolutions that Health Forward is tracking:

• HJR 91 would make it more difficult for citizen-led initiative petitions — like Amendment 2 that expanded Medicaid in Missouri — to succeed on the ballot. This joint resolution would raise the threshold of passage to 2/3rds majority rather than the current simple majority (more than 50 percent).
• A slate of other bills would make it more difficult to vote or otherwise have citizens express their constitutionally-provided right to vote. Here are a couple notable bills/resolutions:
  • HB 1595 would require that all ballots be in paper form and bans the use of ballot drop boxes, which were crucial for voters during the pandemic.
  • HB 2389 bans the donation of money from non-governmental entities for the administration of elections, which means there would be no alternate means to run a fair and smooth election process if the government underfunds elections administration.
  • HJR 94 would only allow an individual to vote with a government-issued photo ID.

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 as Medicine 

Some innovative policy around food and nutritional assistance has 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 seniors and those with disabilities to use their Supplemental Nutrition Assistance Program (SNAP) benefits in restaurants. While the bill made it out of committee, an amendment was added during debate in the Senate to add work requirements, which Health Forward opposes.
• Other bills (HB 2085, HB 2156, HB 2255) have been placed on the House debate calendar, and these add barriers and restrictions, such as limiting access to cash from an ATM for Temporary Assistance Program participants and work requirements for SNAP, which would make navigating these programs more difficult and nearly impossible for working families, especially single-parent homes.

Telehealth 

HB 2510 would allow for doctors licensed in other states to see Missouri patients, greatly expanding the availability of doctors to 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. The Missouri Association of Osteopathic Physicians and Surgeons testified in opposition.

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

Missouri took a positive step toward digital equity when a representative from the KC Coalition for Digital Inclusion was added to the Missouri broadband task force. This representative will help ensure that conversations about the digital divide center both urban and rural areas. There has also been some legislation in this area that moves us in the right direction.

• HB 2675 would help set minimum requirements for broadband projects and HB 2609 specifies provisions relating to the data needed to qualify for a broadband expansion grant.

Health Forward provided testimony in support of HB 2675 to help rural and urban residents in our service area gain access to affordable, high-speed internet. We are monitoring HB 2609 and consulting about the equity implications of the data requirements to qualify for a grant.

Unhoused Missourians

Both the House (HB 2614) and Senate (SB 1106) heard bills regarding requirements for the funding of housing programs, especially those that apply to unhoused Missourians. These bills are problematic and invasive for people in a housing crisis and would make it exceedingly difficult for organizations on the frontlines to access critical state funding to help folks in need of shelter.

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