Let me apologize up front for the length of this post. This past week was important and a bit complicated, and if you’ll read it to the end, you will have a much better understanding of our efforts. It is a bit in the weeds, but facts matter.
My wife and I were adults the day Roe v. Wade was decided. Connie picketed Planned Parenthood and sidewalk counseled women at 47th & Troost (the Planned Parenthood facility in Kansas City) with my support for years. We were involved with the Light House founding in Kansas City, as well as Mothers Refuge in Independence. I have always done everything in my power to advance the cause of life, both as a citizen and as an elected official.
Now, the FRA, which stands for federal reimbursement allowance, is a “tax” health care providers willingly pay into an account that then is matched by the federal government at a higher rate. In total, these funds amount to more than $4 billion, which is about 40% of our Medicaid funding. Without it, our Medicaid program could not be sustained.
Our Medicaid system primarily covers:
Pregnant women and neonatal care up to 185% of federal poverty level.
Seniors in nursing homes who have exhausted their personal savings and now rely on Medicaid funding.
Individuals with developmental disabilities as in home care or day hab, which allows families to get kids and adults with disabilities the therapies and services they need to have a shot at a better life.
Children Health Insurance Program (CHIPs), which provides premiums based on family income.
Every part of Medicaid must comply with federal rules from the Centers for Medicaid and Medicare Services (CMS), and this is where the issue comes in. Myself and many members of my caucus support placing in the FRA a prohibition stating that “no funds shall be expended to any abortion facility as defined in section 188.015 or any affiliate or associate thereof.”
As I said, I as well as other members of my caucus supported that change. However, I believe the language puts us out of compliance with CMS because there is a rule that states any willing provider that qualifies under federal law must be allowed to participate. Being out of compliance doesn’t mean we won’t prevail with the new rule, but it will need to go through a difficult process. With our current federal administration, I’m concerned there’s a reasonable chance we will be found out of compliance. I fear the administration is looking for a state to make an example of, and while I’d be happy to risk the health insurance of senators, I won’t gamble with insurance for our most vulnerable citizens.
Being found out of compliance opens us up to enormous possible Medicaid penalties and clawbacks. For this reason, during debate, we also proposed adding language to the FRA bill which said that defunding Planned Parenthood would happen “at the time of either approval by the Centers of Medicaid and Medicare Services (CMS) or an administrative or judicial action requiring CMS approval.” That Medicaid protection language means our funding would be secure while the process works its way through.
That is the exact language, amazingly, that some sought to strip from the bill for what they called “support” for Planned Parenthood – it’s not. It’s language that doesn’t threaten funding for neonatal care for pregnant moms on Medicaid; funding for seniors, many suffering from dementia, Alzheimer’s or other horrible terminal diseases; funding for families with developmental disabilities who just need a little help. I don’t understand how someone could consider this to be anti-life language – it’s insane. Instead of questioning the sincerity and pro-life credentials of senators who voted to keep the Medicaid protective language in the bill, I’d suggest questioning the judgment of outside groups willing to jeopardize funding for vital Medicaid services.
While the effort to remove the Medicaid protection language from the bill was defeated, the provision along with the defunding language were ultimately not included in the version of the bill approved by the Senate. That said, we were able to prohibit Medicaid paid family planning services from covering “any abortifacient drug or device” used for an abortion. I believe this is an important step forward in protecting life in Missouri.
Quickly, let me touch on a couple of other facts. Twenty-five years ago, Missouri averaged 20,000 surgical abortions. There have been zero this year. Zero. If you are pro-life, this is a huge win and shows the dedication of the Legislature on this issue.
Let me close by summarizing this past week. No member of the Majority Caucus voted against defunding Planned Parenthood. If anyone says otherwise, they are being dishonest. After we saved the Medicaid protective language, the votes were not there to include the defund language with the protective language (I would have voted yes) in the final version of the Senate’s bill. The governor and the Legislature are working on this issue via the rule making process, as Arkansas and Texas have done. It will actually be quicker, but that wasn’t good enough for some looking for a short-term win.
Missouri is just as pro-life today as it was yesterday. In fact, we have advanced the cause of life. I pray we remain that way until this issue is resolved.
I am honored to serve the citizens of the 8th Senatorial District. If there is anything I can do to serve you, please feel free to contact my office in Jefferson City at (573) 751-1464. For information about my committee assignments or sponsored legislation for the 2021 session, please visit my official Missouri Senate website at senate.mo.gov/Cierpiot.