Medicaid tax gets through Missouri House in time for state to avert budget cuts

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Missouri lawmakers on Wednesday sent the renewal of a tax critical to funding Medicaid to Gov. Mike Parson, just ahead of a deadline he imposed for enacting drastic budget cuts across the state.

The House passed the bill 140-13 with no debate or changes to the version Senators approved Saturday after a bitter impasse. It also passed a bill cutting Planned Parenthood out of Medicaid, which died hours later when the Senate adjourned without acting on it.

Parson was waiting to receive and sign the tax bill before day’s end, allowing the state to start the new fiscal year Thursday with the budget lawmakers sent him in May intact.

“We’re here all day,” he said Wednesday morning. “And that means til midnight tonight.”

The renewal keeps in place a tax on hospitals, nursing homes, pharmacies and ambulance services that allows Missouri to obtain a nearly 2-1 match in federal dollars — generating billions to pay for the health care program for the poor.

Without it, Medicaid faced financial disaster, and Parson threatened budget cuts across state government to make up for the shortfall. The tax would have expired Sept. 30 and now will be renewed for three years.

“It would be catastrophic,” House Budget Chair Cody Smith, a Carthage Republican, said of failure to extend the levy.

Missouri has had the tax, called the federal reimbursement allowance or FRA, in place for about three decades, and its renewal has been routine. This year, hardline conservatives in the Senate sought to add provisions banning Medicaid coverage of certain forms of birth control, which they called akin to abortion, and block the program from making payments to Planned Parenthood.

In a concession, Parson called for a special session to renew that tax that also allowed discussion of both anti-abortion measures. Ultimately, the Senate last week abandoned a plan to include birth control coverage bans and rejected the Planned Parenthood language, out of concern from both Democrats and most Republicans that it could violate federal laws.

House Republicans this week made a last-ditch attempt to cut Planned Parenthood out of Medicaid. The House passed the FRA renewal on Wednesday only after spending hours discussing and passing a separate bill to block payments to the provider, which operates the state’s only abortion clinic as well as 11 family planning clinics in Missouri.

The 109-45 vote was rendered moot when the Senate adjourned Wednesday afternoon. Senate President Dave Schatz and Majority Leader Caleb Rowden said in a statement that any further debate would delay would endanger timely implementation of the FRA tax. The current tax expires on Sept. 30 and its renewal does not take effect until at least 90 days after adjournment.

They announced the formation of an interim committee on “Medicaid Accountability and Taxpayer Protection” and said they would work with Parson to make the House’s “initial action to defund Planned Parenthood” permanent.

Parson last week lashed out at the strictest anti-abortion lawmakers and Sen. Bob Onder, a Lake St. Louis Republican whose hardline stance on including the Planned Parenthood ban threatened to derail the FRA renewal.

But he struck a sanguine tone on Wednesday morning. He praised Sen. Paul Wieland, the Imperial Republican who first tacked the birth control language onto the tax bill, and a group of bipartisan female Senators who forced a deal on dropping that provision last week.

“I think everybody understands the stakes,” he said. “Women are at this Capitol just as much as men are, and they should be taking the lead on this. They know more about women’s health care than us men do.”

In a statement, House Speaker Rob Vescovo, Speaker Pro Tem John Wiemann and Majority Leader Dean Plocher said they had supported both the FRA and anti-abortion efforts.

“We are proud of the work done by the House today to approve the FRA renewal so the vital programs that assist many of Missouri’s most vulnerable citizens can continue to be funded,” they said. “We’re also proud of our members for taking a strong stand in defense of the lives of the unborn as we approved House Bill 2 to prevent taxpayer dollars from going to abortion providers.”

Minority Leader Crystal Quade pushed back to reporters.

“All it was was a political move,” she said.

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