As of 6 pm on May 17, 2024, the legislative session has come to a buzzing end. This session has been both sensational and unimpressive, surprising and expected, a sign of the future and a reflection of the past. By the March deadline, 2,619 bills were filed in either the House of Representatives or the Senate. For perspective, ten years ago, the 2013 Legislative session saw 1,146 bills filed. While the number of bills filed may seem sensational to some, what lends itself to be unimpressive is the 29 bills that made it to the “truly agreed and finally passed” phase of legislation, which is even less than the 31 passed during the international pandemic in 2020 when the legislature closed for several weeks. Surprising were the 380,000 signatures collected to reinstate legal abortions, while what was expected was the continued efforts to defund Planned Parenthood (PPH). The nine Senate Democrats holding a 51-hour record-breaking filibuster to block Initiative Petition “reform” was hopefully a sign of the future, while a women’s health omnibus package not being a priority to get across the finish line was a sign of the sad past.
Generate Health tracked over 100 bills related to our advocacy agenda and the overall benefit of the community we serve. The full list of bills can be found on our website. Tracking a bill means we identified and followed actions taken on bills that we either support, oppose, or just want to stay aware of because they could impact our advocacy priorities. None of the bills that we supported made it into law.
Before we dive in, discussion around this legislative session requires some context. The 2024 Regular Legislative Session for the state of Missouri was shaped by two very specific topics: Initiative Petition reform and defunding Planned Parenthood (PPH). Both topics are rooted in the conservative fight against reproductive freedom. An honorable mention, removing Diversity, Equity, and Inclusion programming.
The initiative petition (IP) process is how everyday people can directly impact laws in the Constitution. Historically, when legislators have failed to take up a cause that is important to The People, the people can go through a very detailed process and get the cause on a ballot for Missourians to vote for it. As it stands, when the public votes on a ballot initiative, its ‘one person, one vote,’ and every person in each of the eight congressional districts vote carries the same weight. The proposed legislation was an attempt to alter that process and require a majority vote in a majority of the congressional districts. SJR 74 would have placed IP changes on the August (Primary) ballot and Missourians would have had an opportunity to vote for or against them. The problem that resulted in months of media attention and debate after debate and a 51-hour filibuster was something called “ballot candy”. Ballot Candy is “the pairing of a controversial proposal with a more popular one in a ballot measure to increase the measure’s chances of being approved by voters.” Essentially, it is a tactic used to trick people into voting for one thing by first presenting them with something more palatable. SJR 74 also included language about only U.S. citizens being able to vote and no foreign funding for IP, concepts that are already law. Senate Democrats filibustered twice to get this language removed and to keep voters from being misled. The first filibuster resulted in the ballot candy being removed and the bill going to the House for debate. When the bill came back to the Senate, the ballot candy was reattached. The second filibuster nearly carried out the session with hyper conservative senators, referred to as the Freedom Caucus refusing to do any more business, as their bill had failed.
However, defunding PPH through HB2634, passed. This legislation prohibits “public funding of abortion facilities and affiliates and provisions relating to MO HealthNet providers.” This bill was very specifically targeted at PPH. Though as of right now, abortion is illegal in MO [meaning there are no abortion facilities], conservatives wanted to strip PPH from receiving Medicaid reimbursement for any services including well women’s exams, contraception, sexually transmitted infection and disease testing and treatment, cancer screenings, and any other services they may provide. For perspective, PPH is the one of the largest STI and cervical cancer screeners in the state. Once HB2634 passed the House and Senate, the Freedom Caucus held a 41-hour filibuster demanding Governor Mike Parson sign the bill into law. While the filibuster ended without his signature, it came just days later. As of August 2024, PPH will no longer be a covered provider for MO HealthNet. However, PPH remains committed to providing their services no matter what.
Both topics sucked up time, focus, attention, support, and money that could have been used to pass other bills that would have positively impacted birthing people, families, and infants in our state. Now that we have context, let’s discuss the bills that Generate Health tracked as they relate to our advocacy agenda.
Advocacy Agenda #1:Promote racial equity among social, economic, and structural factors that affect health in families and communities. (Social Determinants of Health)
We tracked several bills related to the SDoH, and none of the bills we supported made it to the finish line.
- Several bills were filed to eliminate grocery food tax (supported)
- None passed.
- HB 1777 (supported)
- Included provisions for SNAP
- Makes individuals with certain felony convictions eligible for SNAP.
- Ended in the Senate after public hearing.
- HB 2385 (opposed)
- Allowed for landlords to refuse vouchers (section-8 or emergency housing) as forms of income.
- Ended in the Senate.
- HB1560 (Opposed)
- Allowed restriction on cash access for Temporary Assistance for Needy Families TANF
- Ended in the House
- HB 2062 (Opposed)
- Requires state law to impose an eviction moratorium.
- Passed
Advocacy Agenda #2: Promote racial equity in maternal health and decrease maternal mortality.
Advocacy Agenda #3: Promote racial equity in infant health and decrease infant mortality.
Sadly, maternal and infant health bills were not only scarce; they also left a lot to be desired. Many of the bills filed that were related to reproductive care were about abortion – which is already illegal in Missouri — not the health and well-being of birthing people and babies. While thankfully no abortion bills were passed, no other reproductive health bills were passed either.
- Several bills were filed to eliminate the tax on period products and diapers (Support).
- 3 doula bills tracked by Generate Health HB 1446, HB 2632 and HB 2654.
- Testimony was submitted by Generate Health in favor of these bills
- HB 1446 & 2632 (Support)
- Identical bills by Rep. Jamie Johnson and Rep. Wendy Housman
- Passed out of Committee.
- Died on the calendar.
- HB 2654 (Support)
- Filed by Rep. LaKeySha Bosley
- Very heated public hearing.
- Failed in executive session.
- Specifically targeted the current spike in syphilis.
- Ended on the calendar.
- HB1777 (Support)
- Provisions for jailed women
- Banned restraints from 3rd trimester through 48 hours after delivery
- Jails must develop procedures for intake and care of pregnant inmates.
- Sleeping conditions
- Dietary
- STI testing and treatment.
- Substance use disorder.
- Mental health treatment
- Post-partum care
- Ended in the Senate
- Provisions for jailed women
Advocacy Agenda #4 Promote access to equitable healthcare.
Access to equitable healthcare has been covered in the areas above with doula reimbursement, the women’s health omnibus bill, and provisions for jailed women. However, there was movement in this session to prevent equitable access to culturally sound care with anti- DEI bills. HB 2619, also known as “do no harm,” was the lead bill in a series of bills that sought to remove funding for DEI programing in Missouri medical school programs. We directly opposed this effort and were happy to see it not cross the finish line. Families deserve providers that look like them, understand them, have cared to learn about them, and are not functioning in racism and biases.
Initiative Petitions
There were four Initiative Petitions that completed the process, collecting the required signatures and bringing the issue to the ballot. Two of those were of interest to us and impact our community.
Minimum Wage and Earned Paid Sick Time Initiative
This initiative would establish a $13.75 per hour minimum wage by 2025, which would be increased by $1.25 per hour each year until 2026, when the minimum wage is $15 per hour. The initiative would also require employers to provide one hour of paid sick leave for every 30 hours worked.
Right to Reproductive Freedom Amendment
The measure would amend the Missouri Constitution to provide the right for reproductive freedom, which is defined as “the right to make and carry out decisions about all matters relating to reproductive health care, including but not limited to prenatal care, childbirth, postpartum care, birth control, abortion care, miscarriage care, and respectful birthing conditions.”
As stated above, these items will be on the November ballot, Generate Health is in support of these initiatives.
So, What Now?
2024 has been a historic year, however, we are just getting into the swing of the election season. This year Missourians have the duty to vote for our president, governor, Lt. governor, mayors, a US senator, eight US House of Representatives, Attorney General, Secretary of State, Treasurer, two State Supreme court justices, 17 state senators, all 163 MO State Representatives, and a host of municipal items. The landscape of Missouri politics will look drastically different in 2025 no matter what. It is up to us to be engaged, meet candidates, and get our political agenda needs out there and ensure the candidates know their constituency.
This session left much to be desired. We need doula reimbursement. Though there is the administrative route through MO HealthNet, it should be law. While the current MO HealthNet administration believes that doula reimbursement is important, administrations change, budgets change, and focus items change. Having doula reimbursement supported by Missouri law would protect this important asset to access. We need Medicaid improvements. The current execution of Medicaid is not working for our people. The Mo HealthNet renewals process has been difficult for families to navigate. Unclear procedures, call center wait times exceeding 1 hour, and procedural mishaps cause thousands of Missourians– mostly children — to be booted from Medicaid and forced to scramble to reenroll. Application processing times soared to a median of 77 days this year, while the federal requirement is a maximum of 45 days. This caused a back log of over 63,000 pending applications in February. We need better transparency in the budget. Birthing people deserve reproductive justice and support. Our families deserve to have close access to healthy foods in fully stocked grocery stores. We all deserve politicians that are doing work in our favor and working towards improving birth outcomes for Black families.
Get locked in! Joining the movement is even more important than ever! Contact kbetts@generathealthstl.org to learn more about how you and/or your organization can partner with Generate Health to improve the health and wellbeing of Black families.
