JEFFERSON CITY — Top leaders in the Missouri Senate say a plan to expand Medicaid coverage for low-income mothers and their babies may be doomed because of abortion-related language attached to the measure.
Days after the Senate gave broad, bipartisan approval to a plan to offer health insurance coverage to mothers and babies for 12 months after a pregnancy, Senate Minority Leader John Rizzo, D-Independence, said provisions added by a pair of conservative Republican senators puts the extension in jeopardy of receiving federal approval from the Centers for Medicare and Medicaid Services.
The language attempts to prohibit women who have abortions from receiving the extended benefits.
“I don’t know why you’d throw a monkey wrench into something that expands medical coverage for new mothers for a year,” Rizzo said. “I don’t know many people who could find things wrong with that.”
Senate President Caleb Rowden, R-Columbia, agreed that the measure, which was given preliminary approval Tuesday, needs to be fixed.
“The House has the ability to make changes they think are necessary,” Rowden told reporters Thursday. “We’ll see what it looks like when it comes back.”
The measure, sponsored by Sen. Elaine Gannon, R-De Soto, and Sen. Tracy McCreery, D-Olivette, is part of a renewed, bipartisan effort to extend Medicaid coverage following the birth of a child as a way to help bolster positive health outcomes in both the infant and the new mom.
The state currently offers the government-funded insurance coverage for two months after a baby is born, but most acknowledge a longer coverage period could help address Missouri’s high maternal mortality rate.
An average of 61 women died each year between 2017 and 2019 while they were pregnant or within a year of their pregnancies, the Missouri Department of Health and Senior Services said in a recent report.
The report added that three out of every four pregnancy-related deaths were preventable.
The extended coverage period has received heightened attention in the Republican-controlled General Assembly now that nearly all abortions are outlawed in Missouri after the U.S. Supreme Court overturned Roe v. Wade in June. The original plan has the backing of anti-abortion lobbying groups.
But, during debate on the floor, Sen. Mike Moon, R-Ash Grove, and Sen. Bill Eigel, a Weldon Spring Republican who is exploring a run for governor in 2024, successfully added language to prohibit postpartum benefits if a women has an abortion.
Sen. Jill Carter, R-Granby, was among those saying the abortion prohibition would help the measure garner enough votes for passage.
But Rizzo and Rowden said the amended version of the bill is unlikely to pass federal muster in order to go into effect.
“I don’t believe CMS will take it that way,” Rizzo said. “What we do know for sure is what they will take. That’s what we should do.”
He added that the situation is reminiscent of prior years when members of the conservative caucus held up budget-related legislation over the issues of Medicaid expansion and abortion.
“You’re in a situation now where the super, super minority of the majority are again imposing their will on the rest of the body,” Rizzo said. “Unfortunately for us, it appears they’ve won for now.”
Along with the Senate bill, at least five similar initiatives have been introduced in the Missouri House, including one backed by House Majority Leader Jon Patterson, R-Lee’s Summit.
House Speaker Dean Plocher, R-Des Peres, also supports the plan, giving Rowden hope that a clean version of the legislation will return to the Senate later this spring.
Rep. LaKeySha Bosley, D-St. Louis, who is sponsoring a version of the extension in the House, said she hopes the wrinkles can be ironed out in the House.
“We all have a consensus that we want this to come out clean because, at the end of the day, we’re trying to lower our maternal mortality rate,” Bosley said. “I see this as an opportunity to negotiate.”
On top of being backed by leaders in both chambers, Gov. Mike Parson also has made the issue a priority this year, putting $4.4 million into his budget proposal to implement a new maternal mortality prevention plan to provide support and address preventable deaths of expecting and postpartum mothers.
An estimated 4,565 women would have coverage extended if the bill passed. The proposal could cost $10.7 million by 2025, a legislative analysis of the measure noted.
“I think we’re all worried about a program that I would argue 90% of both chambers really, really want,” Rizzo said.
The legislation is Senate Bill 45.