What’s Going On in Missouri: A Mid-Session Legislative Recap

The Missouri legislature is on spring break at the moment, so let’s take a look at the health-related bills working their way around the Capitol.

The legislature will reconvene Monday, March 30, before a short Easter break at the beginning of April.

Medicaid Expansion

Proving only that silence is deafening, this session in Missouri has offered disappointingly little movement, or even debate around Medicaid expansion. Despite momentum from last session, the conversation seems to be stalled. A handful of legislative champions have offered a range of Medicaid bills, including:

  • SB 301 (Senator Ryan Silvey, R – Kansas City): Medicaid reform without adult coverage expansion. Extends managed care statewide and expands use of health care homes for the medically frail.
  • SB 419 (Silvey, R – Kansas City): Block grants Medicaid, does not explicitly expand the program.
  • SB 230 (Senator Gary Romine, R – Farmington): Extends managed care throughout the state and moves elderly, blind and disabled beneficiaries into coordinated care organizations. This bill was voted out of the Senate Veterans’ Affairs & Health Committee.
  • SB 287 (Silvey, R – Kansas City): Expands Medicaid for veterans and their families.

Despite the abundance of proposals, none of them fully expand Medicaid. Neither Medicaid reform nor expansion have received much debate in the general assembly. Simultaneously, opponents of Medicaid expansion in Missouri have recently organized to create the Missouri Century Foundation (news article), an organization singularly dedicated to opposing Medicaid expansion.

The debate has been bolstered by Governor Sam Brownback’s signal of support for Medicaid expansion, as well as a plethora of positive news detailing Kentucky’s expansion. Recently released polling data in Missouri shows 80 percent support for a plan to reform and expand Medicaid.

Prescription Drug Monitoring

Missouri is the only state in the U.S. that has not yet enacted a prescription drug monitoring program, an electronic database that monitors controlled substance prescriptions. Such drug monitoring programs can warn of dangerous drug interactions and also reduce prescription drug abuse. SB 63 (Senator David Sater, R – Cassville) and HB 130 (Representative Holly Rehder, R – Sikeston) both offer prescription drug monitoring programs. The House bill has passed and been transferred to the Senate. The Senate bill is on the calendar, waiting for a vote.

Welfare Reform

Both the House and Senate have approved SB24, which would substantially change the state’s welfare program, Temporary Assistance for Needy Families (TANF). The program currently has five-year, lifetime limits on benefits. The Senate reduced the limit to four years and the House reduced it further to 2.5 years. Also under consideration is reinstating work requirements for food stamp beneficiaries and instituting stricter work/education requirements for parents. Of the 73,000 Missouri beneficiaries, 2/3 are children.

Odds and Ends

Just a few other issues to watch…

  • SB 46 (Senator Jason Holsman, D – Kansas City): requires hospital price transparency.
  • SB 89 (Senator Paul LeVota, D – Independence): create an insurance rate review.
  • HB112 (Representative Diane Franklin, R – Camdenton): creates a mechanism for enhanced workforce data collection.

Read Jessica’s mid-session review of Kansas >>


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