Missouri House committee pushes renewal of critical Medicaid tax closer to passage

A Missouri House committee brought a critical tax renewal for the Medicaid program closer to passage Tuesday afternoon.

The Budget Committee advanced the bill to the House floor on a 27-2 vote. After a bitter impasse over the legislation in the state Senate last week, the bill received little discussion.

Instead, the committee spent most of Tuesday’s meeting pushing forward a separate bill blocking Medicaid payments to Planned Parenthood. It is a last-ditch attempt by Republican lawmakers to target the organization during a special session called to renew the tax.

The tax renewal, which the Senate passed Saturday, must clear the House floor on Wednesday free of any changes if lawmakers are to meet a deadline Parson set last week: renew the tax by Thursday or he enacts drastic budget cuts across the state. That leaves little room to include a measure backed by anti-abortion activists to exclude Planned Parenthood from Medicaid, after the state Senate fended off an attempt to insert it last week.

The potential inclusion of a Planned Parenthood ban in the bill roiled the Senate last week. Hardline conservatives insisted on it and Democrats and other Republicans raised concerns it could violate federal law and threaten federal funding, on which the state’s Medicaid program is heavily dependent.

The separate House bill targeting Planned Parenthood, House Budget Chair Cody Smith said, is “the only viable path that we have in my mind at this time to cease Missouri’s Medicaid program from doing business with abortion providers and their affiliates.”

The committee approved it on a party-line vote of 20 to 9. It still faces steep odds of becoming law. If the full House passes it, the Senate would need to return to Jefferson City to discuss it.

Most Senate Republicans have placed their hopes instead in Parson, saying in the past several days that they’ve been assured the state will cut its Medicaid ties with the provider through new regulations or administrative rules.

“I just think it’s a much better way to do it,” Sen. Mike Cierpiot, a Lee’s Summit Republican, told The Star Monday.

A spokesman for Senate Appropriations Chair Dan Hegeman declined to comment on whether Senators would return to entertain the bill.

“We’re going to wait and see what the House does,” he said.

Under federal and state law, the health care program for the poor already does not cover abortions. Compromise language in the tax renewal bill the Senate passed specifies that it also does not cover the abortion pill.

But Planned Parenthood’s status as Missouri’s sole abortion provider — at its St.Louis clinic — has spurred numerous attempts by hard-right Republicans to remove the organization entirely from its role in delivering taxpayer-funded health care to low-income women. The organization also operates 11 family planning clinics across the state that provides birth control, sexually transmitted disease treatments, cancer screenings and other health care.

Opponents said removing it from Medicaid would reduce the options for low-income women to get those services. Of the 38,000 primarily low-income women who visited the Missouri Family Health Council’s statewide member clinics for family planning services, 48% went to a Planned Parenthood, spokeswoman Leslie Pritchard said.

Cutting the provider out could also land the state in a fight with the Biden administration. Federal law allows Medicaid recipients to choose their medical provider, as long as it is qualified.

“I think that would be frowned upon” by the federal Centers for Medicare and Medicaid Services, said Elizabeth Nash, interim associate director of state issues at the Guttmacher Institute, an organization supportive of abortion rights.

But on Tuesday, sponsor Rep. Nick Schroer, an O’Fallon Republican, said he believes the state can cut out Planned Parenthood by considering it an unqualified provider. Federal appeals courts have allowed Republican administrations to do so in Texas and Arkansas.

“Yes, it is going to be litigated but I believe we will be held in compliance,” he said.

Though the committee voted out the tax renewal and the Planned Parenthood bill separately, House Republicans are under pressure from anti-abortion activists to use the tax renewal as leverage for the other measure — a move the Senate rejected last week.

“I believe the Missouri Senate put us all in a difficult place,” said Susan Klein, executive director of Missouri Right to Life.

If the Senate adjourns after the tax is renewed without taking up the second bill, she said, “then we have all agreed to allow Planned Parenthood to still get our federal and state tax dollars.”

The Star’s Jonathan Shorman contributed reporting.