Missouri Independent: Budget, Medicaid funding could dominate final weeks of Missouri legislative session

Budget, Medicaid funding could dominate final weeks of Missouri legislative session

by Jason Hancock, Missouri Independent
March 25, 2024

Missouri lawmakers return to the Capitol Monday with a long list of policy priorities still in flux and only eight weeks to get it all done before the legislative session ends in May.

Yet despite a host of issues dominating debate during the first half of the session, the two top tasks lawmakers must complete before adjournment aren’t in question: Pass the state’s roughly $50 billion budget and renew $4 billion in medical provider taxes vital to sustaining Missouri’s Medicaid program.

A failure to do either would require a special session this summer. And factional infighting among Senate Republicans likely means neither will be easy. 

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Senate leadership and members of the Freedom Caucus have squabbled all session, a continuation of the fissures within the Senate GOP that has mired the chamber in gridlock for much fo the last three years. 

The Freedom Caucus wasn’t impressed with the $52 billion budget proposal laid out by Republican Gov. Mike Parson, and only mildly less dissatisfied with House Budget Chairman Cody Smith’s $50 billion alternative. 

“There’s a real disconnect between the fiscal conservative promises that a lot of Republicans are making in campaign season and what they’re continuing to talk about when we come down to the Senate floor and actually debate policy,” said state Sen. Bill Eigel, a Weldon Spring Republican and member of the Freedom Caucus.

Eigel, who is also a candidate for governor, predicted a long slog through the budget this year. 

“It’s going to take a lot of work,” he said. 

Potential trouble also lurks in the background across the rotunda in the House.

The GOP supermajority in the House is expected to work quickly through the budget this week, with the chamber avoiding the internal dissension that’s plagued the Senate. Yet hovering over the House as it heads into the session’s home stretch is the ongoing ethics investigation of House Speaker Dean Plocher, who is facing a litany of allegations of misconduct. 

The House Ethics Committee is scheduled to hold its fifth closed-door meeting Tuesday, with the timeline for issuing a final report unclear. 

Plocher has already faced calls for his resignation from some Republicans. If the committee concludes he engaged in unethical conduct, the fight over whether Plocher should keep his job could derail the session as lawmakers are trying to finalize the budget. 

Federal reimbursement allowance

Senate Minority Leader John Rizzo, D-Independence, speaks about the second week of the legislative session in a press conference on Jan. 11, 2024 (Annelise Hanshaw/Missouri Independent).

Even if a budget compromise can be reached, the Freedom Caucus has also raised concerns about renewing the federal reimbursement allowance, or FRA — the taxes paid by hospitals, nursing homes, ambulance providers and pharmacies as a mechanism for drawing additional federal funds and boosting payments for Medicaid services.

A Senate bill to renew the taxes before they expire later this year has been stalled over Freedom Caucus demands that it include provisions excluding Planned Parenthood from providing Medicaid services.

Including that provision, GOP leaders have argued, could put the entire program at risk of running afoul of federal law. In an effort to tamp down resistance to passing a “clean” FRA, a separate bill blocking Planned Parenthood from being reimbursed by Medicaid was passed by the House earlier this year. 

“It’s a bipartisan belief that we need to pass (the FRA) clean,” Plocher told reporters, later adding:: “I’m an eternal optimist, and I believe we get it done.”

But time is running out, said Senate Minority Leader John Rizzo, an Independence Democrat. The Senate should have taken up FRA legislation at the beginning of the session instead of waiting until the last minute. 

“I don’t understand why it hasn’t been brought up,” Rizzo said. “I don’t understand why it hasn’t had a really good debate. I mean, it seems like there’s a lot of things that have gotten a lot of time on the floor that are way less impactful than the FRA… Everyone in this chamber knows how essential the FRA is to health care, especially in rural Missouri.”

If the legislature is forced to hold a special session this summer to renew the FRA — which is how it was last renewed in 2021 — it will be the Senate’s fault, said Plocher, a Republican candidate for lieutenant governor. 

“It won’t be because of the House’s actions,” he added. 

‘Ballot candy’

State Sen. Mary Elizabeth Coleman presents her Senate-passed proposal to raise the threshold for passing constitutional amendments proposed by initiative petition to the House Elections and Elected Officials Committee on March 12, 2024 (Rudi Keller/Missouri Independent).

Beyond the budget and FRA, Republicans are determined to make it harder to amend the state constitution through the initiative petition process. 

A version of the proposal cleared the Senate last month when Democrats agreed to end their filibuster in exchange for Republicans stripping out provisions labeled “ballot candy.” 

The bill would require a statewide majority and a majority vote in five of the state’s eight congressional districts to pass a constitutional amendment resulting from an initiative petition or a state convention.

In addition to making it harder to enact constitutional amendments, the legislation included “ballot candy” that would bar non-citizens from voting and ban foreign entities from contributing to or sponsoring constitutional amendments. 

Democrats called the immigration and foreign entities provisions a misleading sleight of hand meant to confuse voters from the issue at the heart of the amendment. Republican leadership agreed to remove them, and the bill was sent to the House. 

But state Sen. Mary Elizabeth Coleman, a Republican from Arnold who sponsored the initiative petition bill, urged a House committee to restore the “ballot candy.”  And she hinted at the idea that Senate Republicans were going to turn to a rarely used procedural move near the end of session to force the legislation through over Democratic opposition. 

Coleman’s bluster infuriated Democrats, who accused Republicans of going back on their word and undermining the negotiating process in the Senate. In response, Rizzo and his fellow Democrats used the filibuster to shut down Senate business for a day. 

Despite the setback, Rizzo said he hopes cooler heads will ultimately prevail. 

“I don’t harbor any ill will or animosity towards (Sen. Coleman),” Rizzo said. “Obviously, she made some mistakes in the House committee.”

Senate Majority Leader Cindy O’Laughllin, a Shelbina Republican, said Coleman “maybe just didn’t think before she made the comments. I think maybe she just didn’t weigh out what the results of that would be.”

The House intended to restore the ballot candy, said state Rep. Peggy McGaugh, a Republican from Carrollton and chair of the House Elections Committee. But the specter of Senate Democrats upending the legislative session could change those plans. 

“They made it clear they don’t like the plan we’re working toward,” she said. “So there will be a lot of give and take there… and I don’t know exactly where we’ll end up.”

Education and child care

Sen. Andrew Koenig, R-Manchester, answers questions about his bill that would expand MOScholars during a committee meeting on Jan. 20, 2024 (Annelise Hanshaw/Missouri Independent).

The most expansive bill to clear the Senate so far this year would expand the state’s K-12 tax-credit scholarship program and allow charter schools to open in Boone County. The bill also includes provisions boosting public school funding and teacher retention efforts.

“This is a great package,” said state Sen. Andrew Koenig, a Republican from Manchester who is sponsoring the bill. “It’s a great package for parents. It’s a great package for kids.”

Meanwhile the House passed open enrollment legislation that would allow a school district to accept transfer students from outside its boundaries. Its sponsor, Republican state Rep. Brad Pollitt of Sedalia, has argued that open enrollment “offers parents the opportunity to select curriculum options to better align with their personal beliefs.”

How either bill will fare in the other chamber is unclear. 

“The House has focused the last few years on open enrollment,” said Senate President Pro Tem Caleb Rowden, a Columbia Republican. “The things that we’re focusing on are a little more involved or a little deeper or a little more holistic.”

One of the first bills to win House approval this year would create tax credits designed to make child care in Missouri more affordable and accessible.

The state continues tograpple with a child care crisis, with about 200,000 children living in parts of Missouri considered“child care deserts” because there are one or fewer child care slots available for every three children.

The bill, sponsored by Republican state Rep. Brenda Shields of St. Joseph, would create three types of credits: for taxpayers who donate to support child care centers, for employers who make investments in child care needs for their employees and for child care providers. 

It won overwhelming approval in the House, and is a priority for both Parson and Senate Democrats. 

But the Freedom Caucus has poured cold water on the idea.

“What we’re focusing on is cutting the tax burden for everybody, not having targeted giveaways and tax benefits for certain groups of folks,” Eigel said. “I want to lower the tax burden for everybody.”

Missouri Independent is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Missouri Independent maintains editorial independence. Contact Editor Jason Hancock for questions: [email protected]. Follow Missouri Independent on Facebook and Twitter.