‘Critical’ Medicaid renewal looms over Missouri legislature with 8 weeks left in session

JEFFERSON CITY, Mo. (WGEM) – Missouri lawmakers entered their annual spring break on Friday, marking what is seen as the “halfway point” of the legislative session, though 11 weeks have passed with just eight remaining.

State lawmakers have yet to complete the renewal of a $4.5 billion funding mechanism which expires this fall.

The Federal Reimbursement Allowance, or FRA, in simple terms, is how the state of Missouri draws down federal dollars to cover its Medicaid program.

If it is not renewed, lawmakers predict catastrophe for Missouri health care, including widespread closures of rural hospitals that depend on those funds.

“We all understand that we’re not going to not renew a $4.5 billion fund that pays for our nursing homes and our rural hospitals and people that are really vulnerable,” said State Sen. Cindy O’Laughlin, the Senate’s majority leader.

“Everyone in this chamber knows how essential and critical that FRA is to healthcare, especially in rural Missouri, and to the state’s budget being solvent,” said State Sen. John Rizzo, the Senate minority leader.

The last time the FRA was up for renewal in 2021, a handful of Republicans stalled the bill, demanding it include language which prohibits Medicaid funds from going to abortion providers.

The Senate failed to pass the measure before the close of the session, forcing the governor to call a special session to see the program renewed.

It was eventually completed without the language demanded by the small group of Republicans.

Many of the same members, now known as the “Freedom Caucus,” have promised to block the bill again unless it contains that same language

“If we’re able to defend those that are doing harm and be able to help fund those that aren’t, we’re willing and able to make that happen,” said State Sen. Rick Brattin, R-Harrisonville. “But until that happens, it’s going to be an issue with this Freedom Caucus.”

The Missouri Budget Project predicts any scenario in which the FRA is not renewed would result in roughly $1.5 billion in cuts to K-12 and higher education and mental health services.

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