With under three weeks left until lawmakers adjourn for the regular session, the Missouri Senate is hoping to hear a routine bill that would help to cover a significant share of the state’s Medicaid costs. The federal reimbursement allowance bill, also known as the FRA, taxes Missouri hospitals and healthcare centers to help with those expenses.

Sen. Bill Eigel, R-Weldon Spring, talked about what it means to pass a “clean” FRA, without other provisions that could muddy up the bill.

“I think it’s got to have a sunset,” he said. “I mean, it has been a tradition in this state that we’re not just going to have an unending healthcare tax on our hospitals in this state. The idea that we could get past the FRA, the idea we could then get past the IP reform debate, and then just permanently put a healthcare tax on the people of this state, that doesn’t make much sense to me.”

Democrats argue that the bill needs to pass to avoid substantial cuts to the state’s Medicaid program. About $4.5 billion in federal aid are at stake if the bill does not pass, something Senate Minority Leader John Rizzo, D-Independence, said could be “catastrophic.”

“I think, ideally, the situation is it’s really hard to balance a budget without knowing if you have $4.5 billion in it,” he said. “You know, it’s the glaring, no pun intended, elephant in the room.”

Members of the Freedom Caucus argue that funding should not go toward funding abortions. Most abortions are banned in Missouri, and state Medicaid funding does not cover abortions.

“There’s a conversation surrounding a lot of our Medicaid programs about work requirements,” chimed Eigel. “So, I think there’s a lot that we, there’s a long way to go on the FRA. I think if folks are serious about levying that tax again, for at least a couple more years in the state of Missouri, I think we should put some big red policies on the table to associate with that.”

Senate Appropriations Committee Chair, Sen. Lincoln Hough, R-Springfield, is not concerned.

“Anyone who’s been here for the past several years saw what happens when we don’t get it done during regular session, and we immediately come back into special,” Hough said. “I think the prudent responsible thing to do is to do our jobs while we’re here and I don’t have any fear that we don’t get this done.”

The state’s health care providers pay this tax so that they can receive reimbursement for treating Medicaid patients.

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