MM Curator summary
Republicans are fighting to prevent Medicaid paying for abortion drugs via withholding support for continuing a financing scheme that sends more money to large hospitals.
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JEFFERSON CITY, Mo. – Missouri lawmakers could be headed back to the capital city as soon as Monday to renew an important tax that funds the state’s Medicaid program after members could not reach a compromise before they adjourned from the legislature’s regular session.
Governor Mike Parson said he’s still planning to make budget cuts if there’s not a solution by July 1 to pass a new Federal Reimbursement Allowance (FRA) program.
“We’re going to have to move forward because I can’t delay it any longer,” Parson told reporters Tuesday. “July 1 there will be withholds, there is no other option for us.”
The FRA is a tax collected from medical providers like hospitals to support Medicaid. House Budget Committee Chairman Rep. Cody Smith (R-Carthage) said the tax brings in $1.6 billion a year.
“For about every FRA dollar we get, we get about two federal dollars for that and then we take all that money and we put it towards our Medicaid program,” Smith said.
The holdup for the General Assembly is if abortion providers and affiliates and certain contraceptives like Plan B should be covered for women who are already on Medicaid. What’s on the line is billions of dollars for the state’s program.
“The Republican party in the state of Missouri has shown no abandonment for women’s reproductive rights,” Senate Minority Floor Leader John Rizzo (D-Independence) said. “They’re trying to conflate abortion and birth control and the two things are not the same.”
Since lawmakers didn’t get it done before they adjourned, they have to come back for a special session since the FRA expires Sept. 30.
“I’m optimistic that we will be able to come to some compromise on a plan that enables us to go in legislate this fairly quickly and get it to the governor’s desk by the end of the month,” Smith said.
Lawmakers said the problem in finding a compromise is whether or not to allow Medicaid to cover contraceptives. During the last week of session, Sen. Paul Wieland (R-Imperial) attached an amendment to Senate Bill 1 that bans the use of FRA funds for contraceptives and abortions.
“You are literally putting $4 billion dollars in flux that is used to provide healthcare for Missourians over contraception, over birth control,” Rizzo said.
Republican Senators met with Parson Tuesday afternoon to try and find a compromise to renew the FRA. Part of the new language in the drafted legislation says:
Family planning as defined by federal rules and regulations; provided that such family planning services shall not include abortions or any abortifacient drug or device unless such abortions are certified in writing by a physician to the MO HealthNet agency that, in the physician’s professional judgment, the life of the mother would be endangered if the fetus were carried to term.
It goes on to say that an “abortifacient drug or device” include Plan B and intrauterine devices (IUD).
“We have a pro-life super majority on the Republican side and many of our members care about those issues,” Smith said.
Missouri has used the FRA for more than 20 years to fund the state’s Medicaid program. Parson said if it’s not renewed, it will more than a billion-dollar hole in the budget.
“If we can stay in the guidelines, if we can have language in there that doesn’t jeopardize the FRA and doesn’t jeopardize our CMS [Centers for Medicare and Medicaid Services], then we would be willing to take a look at something like that,” Parson said.
Rizzo said he hopes the governor “narrows” the call for the special session so lawmakers can pass a “clean FRA.”
“I think that there is still a lot of fence mending that needs to happen that hasn’t happened yet, I also think that we are adults, and we understand that this is something that could be catastrophe to the state of Missouri if we don’t get it done,” Rizzo said.
He believes lawmakers will be back at the Capitol starting Monday to start working on a plan to renew the FRA. Rizzo said the legislation will start in the Senate and then move over to the House.
Parson’s office has not confirmed when legislators will be back in Jefferson City.