Sen. Caleb Rowden’s Legislative Column for the Week of June 28, 2021

Last week, the governor called the Legislature back to the State Capitol for an extraordinary legislative session to reauthorize Missouri’s Federal Reimbursement Allowance (FRA). Simply put, the FRA is a tax on hospitals, pharmacies, ambulances and other health care providers. In 2020, the FRA generated $1.59 billion in provider taxes, but that resulted in an additional $3 billion in federal matching funds. The money raised through the FRA accounts for roughly 40 percent of the cost of Missouri’s Medicaid program, the largest component of the state budget. The FRA is not included in the appropriation bills that make up our state operating budget, but the budget is written with that federal funding in mind, so it is imperative the Missouri General Assembly pass the FRA each year.

At the start of the extra session, several bills were introduced regarding the governor’s extra session call to reauthorize the FRA. Senate Bill 1 originally extended Missouri’s FRA program for five years; prohibited MO HealthNet coverage of certain family services, such as IUDs and Plan B, if they are used to induce an abortion; and deemed any facility that is an abortion provider ineligible for reimbursement under the state’s “Uninsured Women’s Health Program.” Senate Bill 2 concerned only the coverage of contraceptives and reimbursement under the “Uninsured Women’s Health Program. Senate Bill 3 and Senate Bill 4 both only reauthorized the FRA for five years.

Ultimately, my colleagues and I passed SB 1 with two slight changes from the original version. The version we passed reauthorizes the FRA for three years and prohibits MO HealthNet coverage of any abortifacient drugs or devices used to induce an abortion.

The Missouri House of Representatives passed SB 1 on Wednesday, June 30. The extra session bill now heads to the governor for his consideration, and hopefully, his signature.

I am here to serve you, and my office door is always open to your questions, concerns and suggestions. You can reach my staff at 573-751-3931, and you can visit for an array of legislative and constituent resources.