End of session overview

May 13th marked the end of Missouri’s 2022 legislative session. Of the 2,301 bills filed this session, 66 made it across the finish line in the legislature and are considered “truly agreed and finally passed.” Each
of these bills are now waiting to be signed by the Governor.

Although we supported, tracked, and advocated for numerous bills to improve Black maternal and infant health, political infighting dominated the headlines about this year’s session, mostly driven by a small group of conservative right-wing Senators. While some good things passed this session and some bad things didn’t pass this, we were especially sad to see some of our top priorities not make it across the finish line, including the extension of postpartum health care coverage for low-income moms on Medicaid (read more about that below). Further, we are disappointed that in February, Missouri’s Medicaid program pressed pause on implementing a program lawmakers authorized in 2018 to expand health care coverage of substance use treatment for low-income women and birthing people from 60 days to 12 months postpartum. One of the reasons cited was that lawmakers were expected to pass postpartum health care coverage extension this session, which didn’t end up happening. Fortunately, all Missourians who receive health care coverage through Medicaid, including pregnant and postpartum women and birthing people, will retain their coverage due to the continuing federal public health emergency, which is now expected to last through the summer. You can read more about this here.

On the positive side of things, we worked hard this year to protect Medicaid expansion. We are pleased that HJR 117, which threatened funding for Medicaid expansion and imposed onerous work and
community service reporting requirements, never made it out of Committee in the Senate after it was passed in the House. Further, expansion is fully funded in our state budget! Thank you to all of you who
made your voice heard on this issue! It mattered—your voice matters!

With elections happening across the state this fall, we know there will be several new lawmakers in Jefferson City next year, which brings new opportunities. We stand with our partners and other advocates across the state in our hope that Black maternal and infant health, including postpartum health care coverage extension, will be an earnest priority in next year’s session.

So, what exactly happened with postpartum health care coverage extension?

  • Several bills were filed this year to extend postpartum health care coverage for Moms on Medicaid to 12 months after a pregnancy ends. Missouri is one of only 13 states that has not made this policy change. A broad, diverse coalition of partners from across the state began mobilize in support including Generate Health, Kids Win Missouri, Missouri Right to Life, Pro-Choice Missouri, and several health care industry associations.
  • In January, there were several successful Senate hearings on two of these bills, SB 698 (Gannon) and SB 639 (Schupp). These hearings resulted in a combined bill, Senate Committee Substitute for Senate Bills 639 and 698, which was later unanimously passed out of Committee.
  • By February, SCS 698 made it to the Senate floor for discussion and debate. Unfortunately, several members of the Conservative caucus diverted the discussion and attempted to add anti-abortion language to the bills. Before a vote could be taken on any amendment, the bill was tabled and placed on the informal calendar. This move provided an opportunity for the bill sponsors to work with their colleagues on any issues.
  • Meanwhile, parallel efforts began to unfold in the House. Rep. Patterson, Rep. Phifer, and Rep. Bosley each filed their own nearly identical legislation. By March, Rep. Patterson’s HB 2604 began to gain traction, was referred to the Emerging Issues Committee, and then voted out. By early April the bill landed in the House Rules Committee but was never scheduled for a hearing.
  • By late April, as SCS 698 remained stalled on the Senate’s informal calendar and HB 2604 awaited another hearing, hopes for stand-alone legislation began to diminish. However, in early May, there were several attempts up until the 11 th hour of session to add the policy to other bills via the amendments process. At one point, the policy was successfully added to Sen. Rehder’s omnibus health care bill, but was stripped due to the same infighting and obstruction that stalled so many other important policy items this session.

What’s next in Jefferson City?

All the bills that were passed by the legislature now need to be signed by the Governor. Up first are the budget bills. The state’s fiscal year runs from July 1 through June 30, so the Governor must sign the FY23
budget bills before the end of June. Several of this year’s legislative wins were in the budget bills, so we are keeping watch and working to make sure these items stay safe, including the $500,000 line item for
the Cora Faith Walker Doula Training Program.

Another win this session was the establishment of a prison nursery program. At the last minute, the policy was successfully added as an amendment to SB 683, pertaining to child care. The bill would direct the Missouri Department of Corrections to establish a nursery within a women’s correctional facility by July 2025. The bill is on the Governor’s desk awaiting a signature.

We are sad to see several other policies we watched and supported not make it across the finish line this year, including sales tax relief for the purchase of diapers, a policy to require insurance companies to offer an annual supply of contraception, and flexibility for SNAP recipients to use their benefits to purchase hot meals from restaurants. We will continue to work with our partners to promote these policies and many others that will support Black moms, birthing people, and their families for next session.

Finally, in the closing days of the legislative session, the Missouri General Assembly rushed through an ill-conceived tax credit proposal that was added as an amendment to HB 2090. The credit is intended to be an economic recovery stimulus, but costs $500 million and leaves out the very Missourians who need it most, like families earning low wages. We know that economic stability is critical to Black moms, birthing people, and families so we must not leave out families earning the lowest wages from this benefit. Governor Parson has voiced concerns about the bill, and we need your help to encourage him to veto it, which would allow the state to instead invest the funding in the services and infrastructure that would create a more inclusive recovery. Make your voice heard by completing this action alert from our partners at the Missouri Budget Project.

Re-cap of Actions Taken

We mobilized our network to take action in support of the following:

  • HB 2374 (Bosley) to allow women and birthing people receiving health insurance through the Show-Me Healthy Babies program to retain their coverage for 12-months postpartum.
  • SB 698 (Gannon), HB 2604 (Patterson), HB 2644 (Bosley), HB 2242 (Phifer) to extend postpartum health care coverage for Moms on Medicaid to 12 months after a pregnancy ends.
  • SB 641 (Schupp) to require insurance companies to allow individuals to choose to fill a full 12 months’ worth of oral contraception.

We mobilized our network to take action in opposition to the following:

  • HB 2156 (Perkins) to impose work requirements for recipients of SNAP food assistance benefits.
  • HJR 117 (Smith) to put the implementation of Medicaid expansion back on the ballot, subjecting it to an annual appropriation and onerous work reporting requirements.

Additionally, we convened Community Leader Cabinet members and legislators to talk about the importance of postpartum health care coverage, we provided written testimony in support of annual supply of contraception and against attempts to undermine Medicaid expansion, and we joined forces with Missouri Foundation for Health and Kids Win Missouri to present a workshop at Child Advocacy Day about maternal health care policy. Finally, we hosted a two-part storytelling for advocacy training series with community advocates, “Storytelling for Advocacy: Speaking Truth to Power.”

Now What?

During the second half of 2022, we will launch our Annual Impact Reports and Advocacy Toolkit. We will also be defining our 2023 Advocacy Agenda (stay tuned!) and working with our partners and community
leaders to advance our agenda to end racial disparities for Black moms, birthing people, and their families in Jefferson City and beyond.

Generate Health
5501 Delmar Blvd, #B240
St. Louis, MO 63112
phone: (314) 880-5719
email: info@generatehealthstl.org
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