Sen. Karla Eslinger’s Legislative Column for June 28, 2021

Missouri: Solidly Pro-Life

The Missouri General Assembly is back in session. The governor called us back to the Capitol because the Senate failed to pass legislation renewing the FRA, or Federal Reimbursement Allowance, during the regular legislative session that ended in May. 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.

Originally enacted in 1992, the FRA program has remained uncontroversial throughout its history, and has been renewed routinely with bipartisan support. Two recent events converged to result in this program becoming linked to the topic of abortion. The first was a Missouri Supreme Court decision prohibiting statutory changes through the budget process. The other was a White House decision to remove the “Hyde Amendment,” which outlaws federal funding for abortion, from the upcoming federal budget. A number of Missouri senators responded by adding language prohibiting taxpayer funding of abortions to the FRA renewal.

Abortion is a highly charged issue, so I want to make my position clear. I believe in limited government, but I also believe government should do some basic things, and that includes protecting life. I am, and always will be, a pro-life conservative. This is more than just a policy position – this is a deeply held view made up by my faith and compassion for my fellow man. I gladly accepted the chance to stand up for life by casting my vote to renew the FRA and to ensure taxpayer dollars are not used to pay for abortion-inducing drugs in our Medicaid system.

Another thing I’d like to make clear is that, regardless of the FRA, taxpayer funding of abortion is already illegal in Missouri. Since 1986, Missouri statute (section 188.205) has specifically outlawed the expenditure of public funds for abortion. Your tax dollars do not pay for abortions. While proposed amendments to the FRA legislation might have strengthened that policy, failure to add the language does not open the door for public funding of abortions in Missouri, including those conducted by Planned Parenthood.

The Legislature’s inability to renew the FRA program earlier this year put Missouri’s entire Medicaid program in jeopardy. Thousands of impoverished children, disabled individuals and pregnant women stood to lose health care without the FRA. Because Medicaid is a federal entitlement and must be funded, the rest of the state budget was also at risk. In fact, prior to calling the Legislature back into session, the governor outlined more than $780 million in budget cuts that would be necessary if the FRA was not extended.

With the 2022 Fiscal Year beginning on July 1, it was absolutely critical we acted immediately. A number of attempts at compromise FRA legislation were put on the table, but anything short of a “clean FRA” met strong resistance. The primary concern was whether the proposed amendments would put Missouri out of compliance with federal law, and risk billions of dollars in funding. I believe none of the proposed compromises had sufficient votes to pass, so instead of jeopardizing the state budget and actual health care coverage for thousands of Missourians, we chose to renew the FRA before it was too late.

The FRA renewal legislation eventually approved by the Senate forbids the MO HealthNet program from funding abortions or abortifacient drugs or devices that induce an abortion. This language is consistent with what is already contained in Missouri law.

Clearly, some pro-life advocates would have preferred stronger language. Some may even go so far as to say the legislation we passed is not pro-life. I disagree. Providing prenatal care for pregnant women, health care for poor children and services for the severely disabled is the very definition of pro-life. Jeopardizing that care would have cost lives, plain and simple. Additionally, the FRA extension we passed includes stricter language to ensure Medicaid not only doesn’t pay for surgical abortions, but also doesn’t pay for drugs that terminate pregnancies and extinguish innocent life.

This episode is not finished. The House still has to vote on the Senate language, so changes are still possible. Also, the governor has vowed to further strengthen Missouri’s pro-life stance through the rule-making process, and I plan to do everything in my power to help him accomplish this. Do not be confused. Although the recent legislative controversy over the FRA was presented as a showdown over taxpayer-funded abortions, Missouri’s pro-life position as well as my own on this issue was never in doubt. Regardless of what happens with the FRA, your tax dollars do not, and will not fund abortions.

It is my honor to serve the residents of Douglas, Howell, Oregon, Ozark, Ripley, Texas, Webster and Wright counties in the Missouri Senate, and it’s always a pleasure to hear from friends and family back home. If I can help you in any way, please call my Capitol Office at 573-751-1882, or my District Office at 417-596-9011.  You can also visit my webpage at, on Facebook: @SenatorKarlaEslinger, or follow me on Twitter: @SenatorEslinger