After days of stalemate, Missouri Senate renews important Medicaid tax

Politics

JEFFERSON CITY, MO. –​ Senators spent more than 14 hours in session Friday to perfect a piece of legislation that renews an important tax which funds the state’s Medicaid program. 

Lawmakers were called back to Jefferson City Wednesday for a special session to renew the Federal Reimbursement Allowance (FRA) tax. The tax is paid by healthcare providers like hospitals and brings in $1.6 billion for MO HealthNet. The federal government then nearly doubles the tax, bringing in a total of almost $4 billion for Medicaid. 

The day started with Appropriations chairman Sen. Dan Hegeman bringing Senate Bill 1 to the floor for debate just before 10:30 a.m. Friday. The first version of SB 1 would prevent some contraceptives like Plan B and IUDs from being covered under Medicaid. It also would restrict abortion facilities, like Planned Parenthood, from receiving funding.

“It doesn’t outlaw or ban any birth control in the state of Missouri,” Sen. Paul Wieland,” R-Imperial, said. “It doesn’t ban or outlaw abortifacient pills or abortions in the state of Missouri. It does none of those things. All it does is say in our Medicaid program that that’s the part the taxpayers pay for.”

Sen. Lauren Arthur, D-Kansas City, filed an amendment to strip the “family planning language” from the bill to make it a clean FRA. 

“IUDs prevent pregnancy, they are birth control,” Arthur said. “Plan B prevents pregnancy, it’s birth control.”

Multiple Democrats stood up in support of Arthur’s amendment, including Creve Coeur Sen. Jill Schupp. 

“We’re already on shaky ground and shaky ground is my belief here in the state of Missouri,” Schupp said. “For people who don’t want big government, there’s nothing more horrific or personal than government inserting its big hands into a woman’s womb. The most personal of places.”

Senate Minority Leader John Rizzo, D-Independence, said on the floor, without the FRA, ambulances and nursing homes wouldn’t be able to run in Missouri. 

“I hope for the state of Missouri, people stand up and I hope for the people in nursing homes, and I hope for the people calling an ambulance in 60 days you will vote the right way,” Rizzo said. “You’re prolife and you’re not for nursing homes getting funded? 

Arthur’s amendment was voted down with a party-line vote, 10-22, with Sen. Denny Hoskins, R-Warrensburg, and Sen. Mike Cierpiot, R-Lee’s Summit, not voting. 

Onder then filed an amendment that he said would, “protect Missouri taxpayers from funding abortion and abortion providers.” 

“We are told on this issue of protecting innocent human life, protecting Missouri’s taxpayers from being forced to fund abortion providers or abortion facilities or their affiliates, on that issue we should bend the knee, we should kowtow to the federal government,” Onder said. 

Some members were concerned this could risk federal dollars coming into the state. 

“I’m just not as willing as some are to throw the dice and say they might not dare do that because they just might dare do that and then we would be in a real mess,” Cierpiot said. “My insurance isn’t threatened, your insurance isn’t threated but poor peoples’ insurance is.”

Rizzo then called a point of order on Onder’s amendment, which led to Senators standing at ease and then recessing for nearly eight hours. During that time, members met behind closed doors searching for a solution. 

While Republicans caucused, Rizzo met with reporters to talk about the stalemate, saying it was time to call the governor in. 

“I have a lot of respect for the governor, especially what he’s done the last few days in really trying to make his case,” Rizzo said. “I think it’s time now for him to narrow this call, take the guess work out f the Senate, they obviously can’t handle it. Narrow the call to a simple extension of the program and he can do that right now. He can do that ten minutes from now. He needs to narrow the call because this body is unable to handle the responsibility of governing at this point.”

Senators returned to the floor around 9:30 p.m. Friday night, where Hegeman offered a new substitute for the bill that renewed the FRA for five years and defunded Planned Parenthood, pending approval of Centers for Medicaid and Medicaid Services (CMS). 

Onder spoke against the substitute and tried attaching an amendment that would prevent Medicaid coverage for abortion providers and affiliates. That amendment failed in a roll call vote, 12-21. 
Just before midnight Friday, a new substitute was perfected. It was nearly a clean FRA bill with a three-year extension and no language about defunding Planned Parenthood or abortion providers. There is language in the legislation that prohibits abortifacients, but it doesn’t specify them like previous versions. Instead, it says “any abortifacient drug or device that is used for the purpose of inducing an abortion.”

Members adjourned before midnight and returned at 12:30 a.m. to vote on the bill. Eighteen Republicans joined the ten Democrats to pass SB 1, 28-5. Onder called the bill an “embarrassment” before the vote was taken. 

Senate President Dave Schatz, R-Sullivan, and Senate Majority Leader Caleb Rowden, R-Columbia, who both voted in favor of SB 1 released a statement on the passing of the legislation:

“We began this special session with two goals: to protect life and to renew the FRA. Failing to renew the FRA, or playing political games with billions of dollars of Missouri’s Medicaid funding, would have jeopardized our state budget and health care coverage for pregnant women, poor children, and the disabled.  

Senate Republicans have been, and will continue to be, pro-life champions. We led the passage of the heartbeat bill and decades of Republican efforts have brought the number of abortions in Missouri from an all-time high of 20,000 per year to zero.  

We’ve continued to build on our tradition of pro-life leadership by renewing the FRA for three years, stopping taxpayer funding for abortion drugs, and protecting health care coverage for Missouri’s neediest citizens.  

We are proud to have a pro-life partner in Governor Parson—and with his commitment to take necessary executive action, Missouri will soon be equipped to deliver the knockout punch that truly defunds Planned Parenthood once and for all.” 

Executive Director of Missouri Family Health Council Michelle Trupiano released a statement on the renewal of the FRA: 

“Tonight, the State Senate chose to pass an FRA that removed dangerous language equating birth control to abortion and limiting safety-net providers. This is a win for science, MO HealthNet patients, and all Missourians. We applaud the Senators who put people over politics tonight and ushered in a bipartisan resolution on this. The message is clear: it is not a winning strategy to use birth control – which is essential healthcare – as a bargaining chip,” said Michelle Trupiano, Executive Director of Missouri Family Health Council, Inc.

Planned Parenthood Advocates in Missouri also released a statement after the passage of SB 1:

“While access to birth control and Planned Parenthood health centers were protected tonight, the fight for a clean FRA funding bill is not over. This is what it looks like to fight together for the most marginalized people among us. All providers and patients — of Planned Parenthood, nursing homes, hospitals, and other safety-nets — deserve better than to be treated like political bargaining chips. Planned Parenthood Advocates in Missouri and its partners won’t back down, not today, not ever.” 

The FRA has been in place in Missouri for nearly 30 years. House members are set to be in Jefferson City starting Monday to start the process with the goal of taking a vote on Wednesday.

Parson said if the state does not renew the tax, it would cost the state more than $1.4 billion over two years. 

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