Negotiations in the Senate
From where I stand, the Missouri Senate should not have needed to be in session last week, but we did, so we were. To be perfectly honest, we did not pass legislation to renew a little-known, but absolutely vital program called the Federal Reimbursement Allowance, or FRA. Under the FRA, Medicaid service providers pay a tax, and that money entitles the State of Missouri to draw down additional money from the federal government. Last year, the FRA program accounted for more than $4 billion in revenue, which paid for about 40% of Missouri’s Medicaid program.
The FRA began in 1992 as a voluntary program envisioned by health care providers themselves. It was enacted into law during Gov. John Ashcroft’s administration and has expanded to include additional providers over time. Until recently, renewal of the program has been routine and widely supported by legislators of both political parties. As Medicaid costs continue to consume an ever-larger portion of Missouri’s budget, the FRA has gained in importance. Frankly, we can’t balance the state budget without it.
If the FRA is so important, why couldn’t we get it passed during the regular session? Again, to be perfectly frank, we ended up back in Jefferson City in an extra session due to amendments relating to abortion and abortion providers being attached to the FRA bill during the regular session. One amendment prohibited the state from paying for certain drugs and devices used to cause abortions. The other amendment would have defunded Planned Parenthood.
Let me be perfectly clear. I vehemently oppose abortion, and I am absolutely committed to ensuring that no taxpayer dollars are used to fund abortions in Missouri. Full stop.
As strongly as I oppose abortion, I’m also convinced no abortion-related measure can pass out of the Missouri Legislature without a fight. It’s not surprising then that the normally routine renewal of the FRA program got bogged down over the issue of abortion. I believe the pro-life amendments kept the FRA from moving forward in May, and I didn’t expect the extra legislative session to go smoothly as long as the amendments remained. Setting aside testimony we heard from those who support abortion, lawmakers heard compelling arguments why conflating the FRA with abortion was unwise. Even pro-life legislators expressed concern Missouri stood to lose all or part of its Medicaid funding if our restrictions ran afoul of federal rules. Others correctly pointed out that Missouri law already prohibits the expenditure of public funds for abortion.
So, why did supporters of the amendments insist on complicating FRA renewal with measures to protect the unborn? They had some good reasons: The current administration in Washington announced its intention to ignore the long-standing “Hyde Amendment,” which prohibits federal funding of abortion. Also, language in a previous Missouri state budget intended to defund Planned Parenthood was tossed out by the state Supreme Court. These were valid justifications, but the amendments created an extremely sticky situation for members of the Legislature who were simultaneously committed to protecting life, but also aware of the ramifications of blowing a huge hole in the state budget.
After several days of intense negotiations, the Senate approved Senate Bill 1, which renews the FRA for three years and includes a somewhat milder version of the pro-life language. The bill we sent to the House of Representatives says there will be no state funding for “abortions or any abortifacient drug or device that is used for the purpose of inducing an abortion.” After the Senate vote, both sides declared victory. Pro-life legislators – myself among them – pointed to the abortifacient language as an expansion of Missouri’s already strong statutes prohibiting taxpayer-funded abortions. Pro-choice groups claimed that the amendments’ supporters didn’t get everything they desired. Both are correct.
In my opinion, this was an unnecessary fight. Missouri has arguably the strongest laws to protect the unborn in the nation. State law already prohibits taxpayer funded abortions (You can look it up in section 188.205 of Missouri’s Revised Statutes). If anyone regrets that we didn’t get more out of delaying the FRA renewal, in my opinion, it was an unforced error.
In renewing the FRA, we ensure continued health care for thousands of disabled Missourians, pregnant mothers and low-income children. Missouri nursing homes, nearly all which rely on Medicaid funding, will not face the immediate loss of revenue. Regardless of what we did or did not do concerning the FRA program, Missouri is, and will continue to be a pro-life state.
On June 30, Senate Leadership announced the formation of the Interim Committee on Medicaid Accountability and Taxpayer Protection. I am pleased to be member of this committee and will work with the other members to ensure the continued protection of the unborn, ensure Missouri tax dollars are spent in accordance with the values of Missourians and make appropriate recommendations concerning the MO HealthNet program.
It’s my honor to serve as your senator for the 16th District. If you have questions or need any assistance, please call my office at 573-751-5713 or log onto my webpage at https://www.senate.mo.gov/brown for more information.