(The Center Square) – Senate Appropriations Committee chair Dan Hegeman’s Senate Bill 1 was a housekeeping measure to extend for another year the Federal Reimbursement Allowance (FRA), a hospital tax that pays for about one-third of Missouri’s $11 billion Medicaid program.
Under SB 1, the FRA extension would allow the Missouri Department of Health and Senior Services (DHSS) to collect $1.28 billion in hospital taxes each of the next two years. FRA revenues would, in turn, draw $2.391 billion in federal funds each of those two years to the state’s Medicaid program.
Missouri’s recently concluded legislative session featured heated debate over Medicaid funding as lawmakers decided not to fund an expansion of Medicaid that voters approved in August. A federal lawsuit to compel the state to fund Medicaid expansion has been filed.
But renewing the FRA for one or two years is a little-noticed procedural maneuver that rarely draws controversy as it did during the session when conservative senators led by Sens. Paul Wieland, R-Imperial, and Bob Onder, R-Lake St. Louis, objected to the use of Medicaid monies for contraception and abortion.
Wieland successfully attached an amendment to SB 1 that bans the use of FRA funds for drugs or devices “that may cause the destruction of, or prevent the implantation of, an unborn child” and bar the use of public money for “contraceptive treatments,” including abortion.
The amendment stalled SB 1’s advance. It was never heard on the floor again. An 11th-hour effort to adopt the extension as an amendment to a House bill failed and the session adjourned without an FRA extension.
GOP leaders in both Republican-controlled chambers said there will be a special session to extend the FRA before it expires on Sept. 30.
Rep. Sarah Unsicker, D-Shrewsbury, in a Wednesday letter to Parson, asked for a special session to renew the FRA sooner rather than later.
“The FRA is not something that should be the subject of political games. People’s lives rely on Missouri receiving this funding for Medicaid,” Unsicker wrote. “There are currently over 1 million Missourians on the Medicaid program, including over 600,000 children.”
Unsicker cited acting MO HealthNet Director Kirk Mathews’ warning that “the program will be threatened by the end of the year” without the FRA extension, leaving thousands of Missourians, including children, without medical care “they need to survive.”
If there is to be a special session, a coalition of 38 lawmakers from both chambers want Parson to also issue “a general call” to adopt a formal prohibition on the use of public money for abortions and on allocating tax dollars to organizations that provide them.
The group, led by Rep. Nick Schroer, R-O’Fallon, said in a Thursday letter that the prohibition is better adopted sooner rather than later.
“Waiting until the next regular session of the Missouri General Assembly to deal with these problems is not a responsible or viable option,” the letter said. “We urge you to exercise responsible pro-life leadership by making a general call for a special session to prohibit direct and indirect funding of abortion and abortion-related services – leaving it to the Missouri General Assembly to best craft pro-life legislation to be sent to your desk for your signature.”
The prohibition is necessary “to protect Missouri taxpayers and others from being forced to directly or indirectly fund abortion – such as by being forced to fund abortions or abortion access, to reimburse for abortion-causing drugs and devices or to send tax dollars to organizations that perform or induce elective abortions and their affiliates,” the letter states.