Sen. Brian Williams’ Legislative Column for the Week of June 28, 2021

Last week, the governor called the Missouri General Assembly back to Jefferson City for an extraordinary legislative session to address the reauthorization of Missouri’s Federal Reimbursement Allowance (FRA) and other health care provider taxes. The FRA ensures our state continues to receive vital matching federal dollars to help subsidize Missouri’s Medicaid program, MO HealthNet. It is separate from the bills that make up our state operating budget, but the Missouri Legislature must pass legislation extending the FRA program every year. We did not pass this legislation during the regular session because there was disagreement over two amendments that were added to the bill that would restrict women receiving MO HealthNet benefits from accessing certain contraceptives, as well as an attempt to defund facilities who perform abortions and their affiliates, such as Planned Parenthood.

When we gaveled in to begin this extra session, four different versions of this legislation were filed. Senate Bill 1 originally reauthorized the FRA for five years and prohibited MO HealthNet coverage of certain family planning services, including Plan B and IUDs, if they are used to induce an abortion and stated any facility who is an abortion provider would not be eligible for reimbursement under the “Uninsured Women’s Health Program.” Senate Bill 2 concerns the coverage of contraceptives and reimbursement under the “Uninsured Women’s Health Program.” Senate Bill 3 and Senate Bill 4 only reauthorize the FRA for five years. I am supportive of SBs 3 and 4. This legislation has been referred to as a “Clean FRA” because this language is similar to what has been passed the last three years.

There is also a financial aspect to consider. Missouri’s FRA program and the other health care provider taxes included in the legislation generated $1.59 billion dollars in FY 2020, while drawing down an additional $3.07 billion in federal matching funds for the Medicaid program. Altogether, the state could lose around $4.6 billion in funding if the FRA is not passed. Each year, the Legislature has passed the FRA in a bipartisan effort, and to me, it seems odd that all of a sudden it is an emergency to tie legislation that prevents Medicaid recipients from receiving contraceptives to the passage of the FRA. Doctors who testified at the hearing for SBs 1, 2 and 3 agree that birth control, IUDs and Plan B are not abortifacients, and it was troubling to see this legislation imply that and restrict access to this important, and potentially lifesaving, health care.

I believe the issues of abortifacients and Planned Parenthood should wait for the regular session so that we can have a constructive conversation about these issues. Last year, I recognized that discussing my police reform legislation would be better suited for the regular legislative session rather than the extra session held last summer, even though that legislation was extremely important to me. We must pass a clean FRA to ensure our state does not lose billions of dollars in Medicaid funding, and I urged my fellow senators to vote for a clean FRA.

After hours of discussion, my colleagues and I third read and passed SB 1 just after midnight on Saturday, June 26. The Senate’s version of the legislation extends the FRA for three years and does not include the provision that would have defunded Planned Parenthood. The legislation does prohibit MO HealthNet coverage of any abortifacient drug or device used for inducing an abortion, but it does not specifically list IUDs, Plan B and other contraceptives like the previous version of SB 1. I am pleased that specifically listing IUDs, Plan B and contraceptives was left out of the bill, because I believe including them furthered the idea that they could induce an abortion if used in that manner, and that is simply not true.

Senate Bill 1 has been sent to the Missouri House of Representatives for their approval. It is our goal to have this legislation passed and sent to the governor’s desk by Wednesday, June 30, the end of the fiscal year. I am hopeful the House passes the Senate version of the bill to ensure our state does not lose crucial funding for our Medicaid program.

Thank you for reading this week’s legislative column. If you have any questions regarding anything going on in the Missouri Senate, please don’t hesitate to contact my office at 573-751-4106. It is an honor and privilege to represent each of you in the Missouri Senate.