The Missouri Senate passed its version of postpartum Medicaid extension Thursday, but new language in the bill threatens its implementation.
Sponsored by Sen. Elaine Gannon, R-De Soto, the legislation would extend coverage for women receiving Medicaid benefits through pregnancy and for a year after the pregnancy ends. Currently, coverage ends 60 days after a pregnancy ends. The bill had seen widespread support from across the aisle, but additional wording added to the bill, labeled a “poison pill” by Democrats, caused senators from both sides of the aisle to question the viability of the legislation.
“So this morning, four folks, two Democrats, two Republicans voted no on the bill because the language will not accomplish what you want to accomplish, which is to help keep new moms alive in their first year postpartum,” said Sen. Tracy McCreery, D-Olivette.
McCreery had previously helped sponsor the bill and talked positively about the bill on the Senate floor. Sens. Mary Elizabeth Coleman, R-Arnold, Curtis Trent, R-Springfield, and Barbara Washington, D-Kansas City, all voted against the bill, along with McCreery.
The language in question appears twice in the bill: “No woman who knowingly receives services that are in violation of state law shall be eligible for benefits under this subdivision.”
That wording, added as an amendment during committee consideration of the bill, prompted senators to warn that it would exclude women who get elective abortions from the postpartum coverage. The bill would allow coverage to women who have their pregnancy ended involuntarily or necessarily to save their lives.
McCreery and other Democratic leaders labeled the amendment as a “poison pill” because they believe even if the bill gets out of the legislature and is signed by the governor, it will not be accepted by the Centers for Medicare & Medicaid Services, the federal agency required to implement the coverage.
“That language that was inserted is the example of government overreach … and this is exactly the kind of language that CMS will not approve, we cannot treat different health care recipients differently,” McCreery said.
A similar scenario played out in Texas after a bill extending postpartum coverage was passed with language about abortion in 2021. The state has still not received federal approval to implement the extension.
All other Democrats, including Senate Minority Leader Sen. John Rizzo, D-Independence, voted for the bill. However, they called on the House to remove the language regarding abortions.
“So I have great hope, that my colleagues in the Missouri House in both parties, can figure out a way to get this done,” McCreery said.
On the Republican side, Sen. Bill Eigel, R-Weldon Spring, spoke in support of the bill on the Senate floor. He called the bill good conservative policy and pointed out that he went from a hard no last year to a yes.
President Pro Tem Sen. Caleb Rowden, R-Columbia, offered insight into why he thought the controversial wording made it into the bill.
“The motivation for the language was to try to make sure that there wasn’t someone intentionally going to another state or doing something to effectively break our law and then receive these services,” Rowden said.
Rowden acknowledged that he does not find the language necessary and that he does not see a way to functionally enforce the language without government overreach.
“The weaponization of the government against specific individuals .. pregnant moms in this case, is something that gives me heartburn,” Rowden said.
Camden Doherty is a state government reporter for the Columbia Missourian.