Medicaid expansion Archives

What we’re watching next week in Missouri Legislature: budget, oversight hearings and MLB antitrust exemption pushback

April 17, 2021 By Brian Hauswirth

The proposed state operating budget will be heading to the Missouri Senate Appropriations Committee in Jefferson City next week for daily hearings and for consideration. The state Constitution requires lawmakers to approve a balanced budget by early May.

House Budget Committee Chairman Cody Smith (R-Carthage) and State Rep. Brad Hudson (R-Cape Fair) have a discussion on the Missouri House floor on April 1, 2021 (file photo courtesy of Tim Bommel at House Communications)

The Missouri House approved a $34.1 billion state operating budget this month, a budget which does not contain funding for Medicaid expansion. It includes a $76 million increase for foster and adoptive children, including a 45 percent increase to the clothing allowance for foster teens.

Kids Win Missouri policy director Craig Stevenson says the House budget provides unprecedented support for the kinship and foster families who care for the thousands of children in Missouri foster care. The state Department of Social Services (DSS) notes there are currently
13,939 foster care children in Missouri.

“It increases everything from the maintenance, the monthly maintenance payments that foster guardian and adoptive parents get. But then also increases important things like the diaper allowance for people who are caring for infants,” Stevenson told Missourinet this month.

House Budget Committee Chairman Cody Smith (R-Carthage) tells Missourinet that he will not be testifying before the Senate Appropriations Committee next week. He says Committee Chairman State Sen. Dan Hegeman (R-Cosby) will be the Senate handler.

The House has also approved a budget blueprint from Chairman Smith that directs dollars slated for Medicaid expansion for other programs. Smith says it’s a $342 million bill. That includes $88 million for long-term care in nursing facilities, $15.5 million for k-12 school transportation, $2 million for adult high schools, $11.6 million for the Department of Mental Health (DMH) for alcohol and drug abuse treatment, $53 million to DMH for adult community programs and $30 million for programs like respite care, adult day care and home-delivered meals.

House Special Committee on Government Oversight Chair Rep. Jered Taylor (R-Nixa) speaks on the Missouri House floor in April 2021 (file photo courtesy of Tim Bommel at House Communications)

Democrats in the Missouri Senate are expected to try to restore funding for Medicaid expansion, which was approved by 53 percent of Missouri voters in August.

The issue of oversight will also get more attention next week in the Missouri House.

The House Special Committee on Government Oversight plans Monday and Tuesday hearings about operations within the Department of Social Services (DSS) and the state Department of Labor and Industrial Relations (DOLIR). The issues at faith-based boarding schools like the now-defunct Circle of Hope will likely be discussed again.

Prescription drug monitoring program (PDMP) legislation will be heard by the Missouri House Veterans Committee on Tuesday afternoon. The committee will hear testimony from bill sponsor State Sen. Holly Rehder (R-Scott City). The Senate has given final approval to PDMP, which is an electronic database that collects data on controlled substance prescriptions within a state. Missouri is the only state in the nation without a PDMP.

Senate President Pro Tem Dave Schatz (R-Sullivan) supports PDMP, saying it provides a layer of protection against drug and dependency and dangerous drug interactions.

Meantime, the Missouri Senate Rules, Joint Rules, Resolutions and Ethics Committee meets Tuesday to hear testimony from State Sen. Rick Brattin (R-Harrisonville) about his resolution, which urges Congress to end Major League Baseball’s (MLB) federal antitrust exemption. Senator Brattin’s resolution is in response to MLB’s decision to move the All-Star game from Atlanta because of Georgia legislation requiring photo ID.

“This is yet another instance of corporate virtue signaling and sports stoking the culture wars in this country,” Brattin said last week. He also says MLB is undercutting the basis of its antitrust exemption. He notes the exemption has been in place since a 1922 U.S. Supreme Court decision.

Critics of the Georgia law say it will make it more difficult for minorities and the elderly to vote.

Missouri’s gasoline tax will also be discussed this week. The Missouri House Transportation Committee meets Wednesday afternoon at 5 to hear testimony from Pro Tem Schatz (R-Sullivan) about his bill, which increases the state’s gasoline tax by 2.5 cents each year, for a total of a 12.5 cent per gallon increase by 2025. The GOP-controlled Missouri Senate has already given final approval to the bill.

Missouri’s 17-cent per gallon gasoline tax has remained the same since 1996.

What we’re watching this week in Missouri Legislature: federal stimulus funding, state budget and workers compensation issues (AUDIO)

April 12, 2021 By Brian Hauswirth

Testimony involving stimulus dollars under the federal “American Rescue Plan Act of 2021”, alternatives to Medicaid expansion and workers compensation for firefighters and first responders will highlight this week in the Missouri Legislature in Jefferson City.

State Rep. Doug Richey (R-Excelsior Springs) speaks on the Missouri House floor in Jefferson City on March 18, 2020 (file photo courtesy of Tim Bommel at House Communications)

The 2021 session has about a month to go. The last day of session will be Friday, May 14.

A brand-new Missouri House Subcommittee on Federal Stimulus Spending will meet for the first time Monday morning in Jefferson City. They’ll gavel-in at 11 a.m. Committee Chairman State Rep. Doug Richey (R-Excelsior Springs) is humbled by the appointment.

“It is a committee that will be doing some very important work in terms of vetting both the priorities and the need for these federal stimulus dollars that are yet to even be received,” Richey says.

The subcommittee will hear testimony on Monday about capital improvement needs that could be eligible for federal stimulus funds under the Rescue plan. President Joe Biden (D) signed the bill, and House Budget Committee Chairman Cody Smith (R-Carthage) has said that he expects Missouri to receive billions of dollars in federal funding.

“There will be opportunity for several one-time appropriations for capital improvements and deferred maintenance that we know exist throughout the state,” says Richey.

He tells Missourinet that examples include universities, public safety, mental health and hospitals and state buildings.

Chairman Richey is emphasizing the importance of due diligence. He tweeted Saturday that “the American Rescue Plan isn’t funded by tax payer dollars, it’s funded by tax payer indebtedness.”

The Medicaid expansion issue will also come up again this week in the Legislature.

The Missouri House Budget Committee is expected to vote Tuesday on a budget blueprint from Chairman Smith, a plan which directs dollars slated for Medicaid expansion for other programs, including MO HealthNet. That’s the state Medicaid program.

Smith outlined the plan last week. House Bill 21, an eight-page bill, is just over $1 billion. $894 million of that would come from federal funds.

Funding includes $26 million for programs like respite care, adult day care and home-delivered meals. Chairman Smith testifies the funding also includes $88.2 million for funding long-term care services for care in nursing facilities. HB 21 also includes $18 million for k-12 public school transportation, and $2 million for adult high schools. It also includes $11.6 million for treatment for alcohol and drug abuse, and $2.2 million for youth community programs. It also provides about $1 million in additional funding for the State Public Defender System.

State Rep. Robert Sauls (D-Independence) speaks on the Missouri House floor in Jefferson City on March 31, 2021 (photo courtesy of Tim Bommel at House Communications)

House Democrats on the Budget Committee are expected to oppose the plan, saying that 53 percent of Missouri voters approved Medicaid expansion in August. Regardless of the committee vote, the issue will almost certainly be debated again on the House floor soon.

The Missouri House Public Safety Committee will meet Tuesday morning to hear legislation from State Rep. Robert Sauls (D-Independence), which involves workers compensation for firefighters and first responders.

“This is a bill that protects those who protect us. The firefighter cancer presumption bill creates a presumption that if a firefighter develops cancer, he or she got it as a result of the hazardous toxins of which he or she was regularly exposed. There is also a component to PTSD for first responders. I am proud of this bill and it is far overdue,” Sauls tells Missourinet.

Sauls’ House Bill 863 would allow Missouri firefighters and first responders to receive workers compensation for diseases of the heart or cardiovascular system, any infectious diseases, diseases of the body systems or organs from carcinoma, and diseases of the lungs or respiratory tract.

Across the Capitol Rotunda in the Missouri Senate, the chamber is expected to take up legislation involving mechanical contractors early this week. Senate President Pro Tem Dave Schatz (R-Sullivan) tells Missourinet he expects his Senate Bill 11 to hit the floor on Monday.

Schatz’s bill is called the “Missouri Statewide Mechanical Contractor Licensing Act.” Under the bill, the statewide mechanical license for mechanical contractors would be regulated by the Division of Professional Registration, within the state Department of Commerce and Insurance. The bill creates the Office of Mechanical Contractors, within the division.

Pro Tem Schatz also says education reform legislation could go to the Senate floor this week.

Click here to listen to Brian Hauswirth’s full four-minute interview with Missouri House Subcommittee on Federal Stimulus Spending Chairman Rep. Doug Richey (R-Excelsior Springs), which was recorded on April 9, 2021:

Missouri’s House Budget Committee chair outlines alternative to Medicaid expansion; Kirk Mathews is Acting Medicaid director

April 6, 2021 By Brian Hauswirth

Missouri’s House Budget Committee learned new details Tuesday in Jefferson City about a budget blueprint from the committee chair to direct dollars slated for Medicaid expansion for other programs, including MO HealthNet. That’s the state Medicaid program.

Missouri House Budget Committee Chairman Cody Smith (R-Carthage) speaks on the House floor in Jefferson City on April 1, 2021 (photo courtesy of Tim Bommel at House Communications)

House Democrats are expected to oppose the plan, saying Missouri voters approved Medicaid expansion in August.

Budget Committee Chairman Cody Smith (R-Carthage) and the House Appropriations director presented House Bill 21, which is an eight-page bill. It’s just over $1 billion, with $894 million of that coming from federal funds.

“This is an appropriation, a rate increase, that again as you (the House Appropriations director) noted, it’s written as a one-time increase. I think it’s up for up for question as to whether or not this should be a general revenue increase, or perhaps an f-map increase,” Smith testifies.

He says this involves a one-time nursing facility rate increase of about $10 per day.

While Chairman Smith opposes Medicaid expansion, his plan would provide an additional $735 million to the MO HealthNet Division for transitional payments. House Appropriations Director Glenn Fitzgerald testifies this is a brand-new proposal.

“This is 735-and-a-half million (dollars) federal funds for transitional payments related to Medicaid reform,” Fitzgerald testifies.

Then-State Rep. Kirk Mathews (R-Eureka) speaks on the Missouri House floor in Jefferson City on April 7, 2016 (file photo courtesy of Tim Bommel at House Communications)

HB 21 also includes $18 million for k-12 public school transportation, and $2 million for adult high schools. It also includes $11.6 million for treatment for alcohol and drug abuse, and $2.2 million for youth community programs. It also provides about $1 million in additional funding for the State Public Defender System.

There was no testimony in support or in opposition to Smith’s bill on Tuesday. Chairman Smith tells the audience that he hopes for a mark-up on either Thursday or Monday. This is a short week in Jefferson City, due to the Easter break.

Medicaid is a federal and state program that assists with medical costs for residents with limited incomes. 53 percent of Missouri voters approved Medicaid expansion in August, although it failed in 105 of the state’s 114 counties. Rural House members from those districts have led the opposition to funding Medicaid expansion.

House Democrats and Amendment Two supporters say Missouri voters have spoken. They say Medicaid expansion will help the working poor by expanding the program for residents between the ages of 19 and 64 with an income level at or below 133 percent of the federal poverty level.

The House voted to give final approval last week to a $34.1 billion state operating budget, which does not contain funding for Medicaid expansion.

We also learned during Tuesday’s one-hour hearing that former State Rep. Kirk Mathews (R-Eureka) is serving as the interim director at Missouri Medicaid, with Director Todd Richardson out on leave.

Mathews has been MO HealthNet’s chief transformation officer. He was first elected to the Missouri House in 2014 and and served two terms, from 2015-2018.

What we’re watching this week in the Missouri Legislature: PDMP, budget, foster care and human cloning

April 5, 2021 By Brian Hauswirth

Legislation that would create a prescription drug monitoring program (PDMP) is expected to receive final approval from the Missouri Senate in Jefferson City on Tuesday.

Senate Majority Leader Caleb Rowden (R-Columbia) tells Missourinet that the PDMP issue should come up tomorrow. That’s when state lawmakers return to Jefferson City, following the Easter break.

State Rep. Robert Sauls (D-Independence) speaks on the Missouri House floor in Jefferson City on March 31, 2021 (photo courtesy of Tim Bommel at House Communications)

The Senate voted to give initial approval to PDMP last week, and it had bipartisan support. Senate President Pro Tem Dave Schatz (R-Sullivan), who voted for Senate Bill 63, tells Missourinet Sullivan affiliate KTUI that informed doctors make better decisions.

“49 states currently have a PDMP, and actually it just provides a layer of protection against drug and dependency and dangerous drug interactions,” Schatz tells KTUI.

A PDMP is an electronic database that collects data on controlled substance prescriptions within a state. Missouri is the only state in the nation without a PDMP.

Opponents of Senate Bill 63, including State Sen. Mike Moon (R-Ash Grove), worry about potential data breaches.

Pro Tem Schatz also says the state operating budget will get a lot of attention in his chamber during the next five weeks. The House has approved a $34.1 billion budget, that does not include funding for Medicaid expansion. The budget now heads to the Senate.

“The governor had made recommendations. The House has made their modifications to it and now it’s our turn to work through the things that we think are priorities in funding in this state,” says Schatz.

The state Constitution requires Missouri lawmakers to approve a balanced budget, by early May.

State Rep. Sara Walsh (R-Ashland) speaks on the Missouri House floor in Jefferson City on March 22, 2021 (photo courtesy of Tim Bommel at House Communications)

Across the Capitol Rotunda in the Missouri House, the Budget Committee meets Tuesday afternoon at 12:30 to hear testimony from Committee Chairman Cody Smith (R-Carthage) about his budget proposal to use Medicaid expansion funding for other programs.

Medicaid is formally known as MO HealthNet, and it’s a federal and state program that assists with medical costs for residents with limited incomes. 53 percent of Missouri voters approved Medicaid expansion in August, although it failed in 105 of the state’s 114 counties. Rural House members from those districts led the opposition to Medicaid expansion last week. Amendment Two supporters say the measure expands Medicaid for residents between the ages of 19 and 64 with an income level at or below 133 percent of the federal poverty level.

Chairman Smith says Medicaid expansion would help able bodied adults, many who choose not to work. He’s filed a bill to use the $1.9 billion to instead support seniors in nursing homes, to provide care for the developmentally disabled and to expand mental health programs. It would also increase k-12 school transportation funding. That proposal will be outlined on Tuesday.

Meantime, the Missouri House Emerging Issues Committee meets Tuesday evening at 5, to hear a foster care proposal from State Rep. Robert Sauls (D-Independence). House Bill 1335 would prevent children from being aged out of foster care during a pandemic.

“During uncertain and difficult times, our most vulnerable children shouldn’t have to worry about homelessness,” Representative Sauls tells Missourinet. “That’s why I sponsored HB 1335. I want to make sure that during a moment of crisis, the children of Missouri have the stability that they need.”

Foster care continues to be a bipartisan issue at the Missouri Capitol. It’s also a top priority for House Speaker Rob Vescovo (R-Arnold).

The human cloning issue will also come up this week in a House committee. The Children and Families Committee will hear testimony on Wednesday morning from State Rep. Sara Walsh (R-Ashland), which would prohibit public expenditure of public funds for research projects involving abortion services and human cloning.

Walsh’s proposal is House Bill 852.

Medicaid expansion not included in final Missouri House budget; heated floor debate involves scripture

April 1, 2021 By Brian Hauswirth

After a heated floor debate that included numerous biblical references, the Missouri House voted Thursday afternoon to give final approval to a $34.1 billion state operating budget. The House budget does not contain funding for Medicaid expansion.

House Budget Committee Chairman Cody Smith (R-Carthage) and State Rep. Brad Hudson (R-Cape Fair) have a discussion on the Missouri House floor on April 1, 2021 (photo courtesy of Tim Bommel at House Communications)

The operating budget now heads to the Missouri Senate, and Medicaid expansion supporters hope senators will include the funding. The state Constitution requires Missouri lawmakers to approve a balanced budget, by early May.

Medicaid is formally known as MO HealthNet, and it’s a federal and state program that assists with medical costs for residents with limited incomes. In August, 53 percent of Missouri voters approved Medicaid expansion, although it failed in 105 of the state’s 114 counties. Rural House members from those districts led the opposition to Medicaid expansion this week.

Amendment Two supporters say the measure expands Medicaid for residents between the ages of 19 and 64 with an income level at or below 133 percent of the federal poverty level.

House Republicans, led by House Budget Committee Chairman Cody Smith (R-Carthage) say Medicaid expansion would help able bodied adults, many who choose not to work. Smith has filed a bill to use the $1.9 billion to instead support seniors in nursing homes, to provide care for the developmentally disabled and to expand mental health programs.

State Rep. Doug Richey (R-Excelsior Springs), who serves on the House Budget Committee, supports Chairman Smith’s position. Richey says it’s important for state government to prioritize.

“What we are doing in this is we are prioritizing the most vulnerable among us,” Richey tells House colleagues.

State Rep. Michael Burton (D-Lakeshire) speaks about Medicaid expansion on the Missouri House floor on April 1, 2021 (photo courtesy of Tim Bommel at House Communications)

The Missouri House Health and Mental Health Policy Committee’s top Democrat is criticizing House Republicans for approving a budget that doesn’t include Medicaid expansion. She voted against the budget bill.

“In 2010 I became an activist and supported President (Barack) Obama’s Affordable Care Act, because it was the right thing to do and thank God that I did. Because it saved my life,” State Rep. LaDonna Appelbaum (D-St. Louis County) tells colleagues.

Appelbaum also talked about her experience with chemotherapy.

Thursday’s debate included numerous references to the Bible, with lawmakers in both parties invoking Jesus’ name and quoting scripture. State Rep. Michael Burton (D-Lakeshire) asked Republicans what Jesus would do about people in need without health care, and State Rep. Trish Gunby (D-Manchester) notes her United Methodist Church believes health care is a right.

But State Rep. Ben Baker (R-Neosho), a minister and former dean of students at Neosho’s Ozark Bible Institute, quoted the Apostle Paul to the Thessalonians on the floor.

“If you don’t work, you don’t eat,” Baker tells the House. He accuses House Democrats of hypocrisy, and State Rep. Nick Schroer (R-O’Fallon) agreed. Schroer says Democrats quote the Roman Catholic Church and other religions, when it’s something they agree with.

State Rep. Keri Ingle (D-Lee’s Summit), quoted Matthew Chapter 25 in a Thursday tweet.

“Then the king will say to those at his right hand, ‘Come, you that are blessed by my Father, inherit the kingdom prepared for you from the foundation of the world; for I was hungry and you gave me food, I was thirsty and you gave me something to drink.”

Governor Parson was asked about the House’s effort on Wednesday, during a live interview on Missourinet Sedalia affiliate KDRO (AM 1490).

“We’ll have to see how that goes in the Senate there. We did put the money in the budget for that,” Parson tells KDRO. “People did vote for it. Although I didn’t support it (Medicaid expansion) at the time but the reality of it is, the people of the state voted for it. I thought it was my obligation as governor to make sure we try to get it implemented. We’ll see though. The House voted against that … a little different maneuver I want to say, I guess. We’ll see what the Senate does and we’ll see how it comes out at the end of the day.”

Missouri lawmakers have left Jefferson City for their Easter break. They’ll return to the Capitol on Tuesday.

What we’re watching this week in Missouri Legislature: Medicaid expansion, budget, PDMP and proposal to reduce Missouri House’s size

March 29, 2021 By Brian Hauswirth

The state operating budget and prescription drug monitoring program (PDMP) legislation will likely take center stage in the Missouri Legislature in Jefferson City this week.

Missouri House Budget Committee Chairman Cody Smith, R-Carthage, testifies before a House committee in Jefferson City on February 24, 2021 (file photo courtesy of Tim Bommel at House Communications)

Governor Mike Parson (R) has proposed a $34.1 billion state operating budget. House Budget Committee Chairman Cody Smith (R-Carthage) tells Missourinet that he hopes to see the House give initial and final approval to the operating budget this week. The state Constitution requires Missouri lawmakers to approve a balanced budget, by early May.

Once the budget goes to the House floor this week, there will likely be a floor debate on the issue of Medicaid expansion.

Medicaid is formally known as MO HealthNet, and it’s a federal and state program that assists with medical costs for residents with limited incomes. 53 percent of Missouri voters approved Medicaid expansion in August, although it failed in 105 of the state’s 114 counties. Amendment Two expands Medicaid for residents between the ages of 19 and 64 with an income level at or below 133 percent of the federal poverty level.

Last week the House Budget Committee voted against funding Medicaid expansion. Chairman Smith issued a statement, which says the expansion would help able bodied adults, many who choose not to work. He’s filed a bill to use that money to support seniors in nursing homes, to provide care for the developmentally disabled and to expand mental health programs. Smith also wants to use some of the money for additional public defenders.

During his January State of the State Address, Governor Parson pledged to move forward with implementation of Medicaid expansion, because voters approved it.

House Minority Leader Crystal Quade (D-Springfield) and other House Democrats have called a Statehouse news conference for Monday afternoon at 1 to address the issue. Leader Quade and House Democrats say Missouri voters have spoken. She describes the Budget Committee’s decision as an irresponsible attempt by House Republicans to defund Missouri’s Medicaid program.

State Sen. Holly Rehder (R-Scott City) speaks on the Missouri Senate floor in Jefferson City on March 9, 2021 (file photo courtesy of Harrison Sweazea at Senate Communications)

Across the Capitol Rotunda in the Missouri Senate, PDMP should hit the Senate floor this week. State Sen. Holly Rehder (R-Scott City) has filed PDMP for the ninth straight year. Rehder filed it for the eight years she served in the House. She was elected to the Missouri Senate in November, and has filed Senate Bill 63.

Senator Rehder delivered a passionate speech on the Missouri House floor in May, revealing to colleagues that her late mother and late sister were both sexually assaulted multiple times and that they turned to prescription drugs for their pain.

“I look forward to having that (Senate floor debate) conversation, obviously this is something that (State) Senator Rehder is very passionate about. When she was in the House, I carried that legislation myself (and) tried to find a resolution for that,” Senate President Pro Tem Dave Schatz (R-Sullivan) told Missourinet last week.

A PDMP is an electronic database that collects data on controlled substance prescriptions within a state. Missouri is the only state in the nation without a PDMP.

Rehder and other supporters say Missouri’s medical professionals must have knowledge of what their patients are on, prior to prescribing more medication. Bill opponents such as State Sen. Mike Moon (R-Ash Grove) worry about potential data breaches involving your prescription information.

While both the Missouri House and Senate approved PDMP in 2020, they approved different versions of the bill.

Pro Tem Schatz says education reform bills will also likely be debated on the floor this week. He also expects some long nights between now and May.

“Not sure exactly the floor schedule, but would anticipate working longer hours from now till session ends,” Schatz tells Missourinet.

Another interesting issue that will be discussed in a Missouri House committee this week involves reducing the Missouri House’s size.

State Rep. Travis Fitzwater (R-Holts Summit) is proposing a constitutional amendment that would reduce the Missouri House from 163 to 136 members. Fitzwater will present his proposal Wednesday afternoon to the House Elections and Elected Officials Committee.

Fitzwater’s proposed House Joint Resolution 34 is similar to his 2019 proposal, which failed. Missouri currently has 197 lawmakers, although there is one House vacancy. Fitzwater says it’s the seventh-largest Legislature in the nation, and that Missouri has more state lawmakers than any of its bordering states.

Missourians ratified a constitutional amendment in 1966, which locked in the number of House seats at 163.

The Missouri House and Senate will both gavel-in Monday afternoon at 4 in Jefferson City.

Outgoing Missouri State Rep. Deb Lavender reflects on her six years in Jefferson City (AUDIO)

December 9, 2020 By Brian Hauswirth

A veteran Democrat on the Missouri House Budget Committee will be leaving Jefferson City at the end of the month, after losing a Senate race to State Sen. Andrew Koenig, R-Manchester.

State Rep. Deb Lavender, D-Kirkwood, speaks on the Missouri House floor in Jefferson City on May 15, 2020 (file photo courtesy of Tim Bommel at House Communications)

State Rep. Deb Lavender, D-Kirkwood, was elected to the House in 2014 and served three terms. She’s most proud that Missourians approved Medicaid expansion in August.

“I guess what I can say I’m proud about is my individual district (the 90th in St. Louis County) passed that by 70 percent,” Lavender says. “So I think my six years of educating my district why Medicaid expansion is important, I think that’s the first thing for the state of Missouri that I think is the best thing that’s happened in a long time.”

Medicaid is a federal and state program that assists with medical costs for residents with limited incomes. 53 percent of Missouri voters approved Amendment Two, which will provide healthcare to Missourians who earn less than $18,000 annually.

Lavender is hopeful that some of the rural hospitals that have closed in recent years will re-open, now that Missouri voters have approved Medicaid expansion. She says the issue is important statewide.

“We’ve closed ten hospitals over the last decade and especially in our day of the COVID virus right now, people are traveling to St. Louis for their medical care,” says Lavender.

Amendment Two expands Medicaid for residents between the ages of 19 and 64 with an income level at or below 133 percent of the federal poverty level.

The implementation of Medicaid expansion will take place in 2021. House Budget Committee Chairman Cody Smith, R-Carthage, has said it’s projected to cost $200 million in state general revenue and $1.8 billion in federal funding each year.

The Missouri Chamber of Commerce, Lavender and other supporters say Medicaid expansion will create more than 16,000 new jobs annually during its first five years, while increasing personal income by $1.1 billion annually.

Another issue Representative Lavender has tried to raise awareness about is fund balances. She is the ranking Democrat on the Missouri House Appropriations Subcommittee on health and social services.

Lavender says Missouri currently has more than 450 individual bank accounts, with $6.8 billion in the bank. She’s disappointed that more hasn’t been done in Jefferson City with the fund balances.

“What I have figured out is that there’s no one person accountable for fund balances,” Lavender says. “But in some cases, I think it’s a place where we have learned to hide money.”

Lavender questions whether all of that money is needed. She says if it’s not needed, it should be spent appropriately. She also supports decreasing some professional license fees.

Lavender says her future is still to be determined. She notes she has always practiced as a physical therapist during her time in Legislature, and has kept her physical therapy practice during the last 18 months of campaigning.

She’s also still interested in state government and in the fund balances. She emphasizes that she has enjoyed serving on the House Budget Committee, and in the Legislature.

Click here to listen to Brian Hauswirth’s full interview with State Rep. Deb Lavender, D-Kirkwood, which was recorded on December 7, 2020:

Boonville hospital closing and Medicaid expansion emerge as issues in key Missouri Senate race (AUDIO)

November 2, 2020 By Brian Hauswirth

Both major parties are pouring money and resources into a mid-Missouri state Senate race, a race that could determine whether Republicans keep a veto-proof majority in that chamber.

The race features Senate Majority Leader Caleb Rowden, R-Columbia, and former State Rep. Judy Baker, D-Columbia.

The district covers Boone and Cooper counties, along the I-70 corridor. While Columbia and Boonville are the two major cities in the district, there are also numerous small towns and farms across the two counties.

Rowden, who served two terms in the Missouri House from 2013-2016, won the Senate seat in 2016 by defeating then-State Rep. Stephen Webber, D-Columbia. Rowden had 45,335 votes, to Webber’s 43,179. Rowden won the race by about two-and-a-half points.

The majority leader is the two number two position in the Missouri Senate. Rowden says serving as majority leader gives him a larger role in impacting the agenda.

“For me that’s making sure that we find a way to get past COVID, trying to find a way to make sure that small businesses have what they need on the back end of COVID, that’s going to be a challenge,” Rowden says. “Trying to make sure the budget situation is stable.”

Rowden also says transportation is huge in the district, noting the importance of an $81-million dollar federal grant to replace the aging I-70 Rocheport bridge. Rocheport is just west of Columbia.

More than 12 million vehicles cross the massive bridge annually, including three million trucks. The bridge connects Boone with Cooper county, across the Missouri River. The current bridge is more than 60 years old, and the state Department of Transportation (MoDOT) has said it’s in poor condition.

Judy Baker served two terms in the Missouri House, from 2005-2008. She left her House seat to run for an open U.S. House seat in 2008, narrowly losing that race to Blaine Luetkemeyer, R-St. Elizabeth, who’s now in his sixth term.

If elected to the Missouri Senate, Baker’s top priority is implementing and protecting Medicaid expansion, which was approved by Missouri voters in August.

“We just passed it (in August) and in this (senatorial) district, it passed with 62 percent of the vote. And my opponent, of course, has voted against it every time he could,” Baker says.

Medicaid expansion supporters say it will provide healthcare to Missourians who earn less than $18,000 annually.

This year’s closing of a hospital in Boonville has emerged as an issue in this race. Baker tells Missourinet that Pinnacle Regional Hospital in Boonville and some other hospitals would have been saved by Medicaid expansion.

“Those hospitals would have been able to stay in their communities, had they had some kind of revenue for the patients they were already seeing,” says Baker.

But Rowden tells Missourinet that the Boonville hospital closed because of mismanagement, saying hospital leaders in Boonville didn’t have the best interest of the community at heart. Rowden disagrees with Baker on Medicaid expansion.

“Well Medicaid expansion wouldn’t keep any rural hospital open, and there’s no data to back that up,” says Rowden. “I do think the infusion of federal dollars could have postponed the inevitable, in some cases.”

The Missouri Hospital Association says ten rural hospitals have closed in Missouri, since 2014.

Rowden and Baker are also clashing over the initial cost of Medicaid expansion, with Rowden saying it will cost $300 to $500 million in the first five years. He says the money has to come from somewhere, and doesn’t want it coming from Mizzou.

Baker says Medicaid expansion would be an economic boost to hospitals and to the towns that have hospitals, especially rural areas.

Republicans currently control the Senate 23-8, with three vacancies. Two of the three vacancies are in the heavily-Democratic Kansas City area, and one is in southeast Missouri, a GOP stronghold.

A veto-proof majority in the Missouri Senate is 23 Senate seats.

Democrats hope to unseat both Majority Leader Rowden and State Sen. Andrew Koenig, R-Manchester, on Tuesday. If that happens and if the other Senate races end up as expected, Republicans would have 22 seats, one short of a veto-proof majority.

Governor Mike Parson (R) noted the importance of Rowden’s seat, during a speech last week to supporters at Emery Sapp and Sons in Columbia. Parson spoke directly to the construction workers in the back of the room, saying “I need him,” referring to Senator Rowden.

Rowden’s other top priorities include protecting funding for Mizzou, as well as K-12 and other higher education funding.

Baker is also focused on the COVID pandemic, and says any economic recovery should be geared toward working families.

Click here to listen to Brian Hauswirth’s full interview with Missouri Senate Majority Leader Caleb Rowden, R-Columbia, which was recorded on October 28, 2020:

Click here to listen to Brian’s full interview with former State Rep. Judy Baker, D-Columbia, which was recorded in Columbia on October 29, 2020:

Parson and Galloway focusing on rural Missouri in final days of campaign; both appealing to blue-collar voters (AUDIO)

October 30, 2020 By Brian Hauswirth

The two main gubernatorial candidates are focusing on rural Missouri again Friday, and during the final days of the campaign.

Governor Mike Parson (R) brings his “Mike works bus tour” to four rural western Missouri towns: his hometown of Bolivar, as well as Clinton, Belton and El Dorado Springs. He’ll finish Friday evening in Springfield.

The governor tells Missourinet he feels confident about where the race is and that he’s on message. Parson also says that if he wins Tuesday, he’ll continue to focus on putting people first.

“I think what we seen what we did by taking the largest income tax cut in our state’s history, by creating 40,000 new jobs by focusing on workforce development and infrastructure,” Parson says, highlighting achievements of his term.

Parson will speak at Friday evening’s “Keep Missouri Red Rally” in Springfield, with former White House Press Secretary Sarah Huckabee Sanders. Sanders will also join the governor Saturday for a rally in eastern Missouri’s St. Peters.

Missouri State Auditor Nicole Galloway, the Democratic gubernatorial nominee, will meet Friday morning with Teamsters Union members in Springfield and with UAW members in Pleasant Valley.

She campaigned Thursday in Columbia, before heading to southwest Missouri’s Marshfield and Springfield. During an interview with Missourinet outside her bus in Columbia, Galloway says rural voters tell her that Jefferson City is disconnected from what matters to them, in their communities.

“Rural hospitals are closing. Jobs are leaving the area,” Galloway says. “They’re concerned about funding for their schools, which are the center of those rural communities.”

The Missouri Hospital Association (MHA) says ten rural hospitals have closed in Missouri, since 2014. Click here to see the full map and years. To be clear, several of those closings happened when Governor Jay Nixon (D) was in office.

But several have also happened during the tenure of Governors Eric Greitens (R) and Parson.

While Parson and Galloway disagree on numerous policy issues, one thing they both have been doing during the campaign’s final stretch is campaign heavily in rural towns across the state.

Galloway says her top priority, if elected governor, will be implementation of Medicaid expansion.

“Making sure that not only folks have access to affordable health insurance, but also have access to health care, meaning we can keep our rural hospitals open and open clinics in parts of our state that desperately need it,” says Galloway.

In August, Missouri voters approved Medicaid expansion for residents between the ages of 19 and 64 with an income level at or below 133 percent of the federal poverty level. While the issue was defeated in 105 of Missouri’s 114 counties, Galloway notes it passed by six points statewide, and that hundreds of thousands of votes from rural residents were key to its passage.

Galloway also says Missouri needs a reset on COVID strategy, so people can get back to work.

During a campaign stop Tuesday at Emery Sapp and Sons in Columbia, Governor Parson emphasized his rural roots, and talked about growing up in southwest Missouri’s Wheatland. He also discussed saying the Pledge of Allegiance in school.

He’s also emphasizing his experience.

“I think what people are seeing right now with everything we’ve been through is experience does matter at a time like this, and I think that’s one of the things I have,” says Parson. “All the way from serving my country in the military, law enforcement, being a business owner.”

Parson says it’s important to take a balanced approach to combating COVID, and that it’s crucial to look at the state as a whole. He says businesses are opening back up, and children are back in school.

Both candidates are appealing to blue-collar voters.

Parson praised their work ethic during his speech at Emery Sapp and Sons, talking about the workers wearing coveralls in the back of the room. He noted he had done work like that. It drew applause from the audience.

As for Galloway, she told her audience on Thursday that Governor Parson’s supporters want to make Missouri a right-to-work state. She’s pledging to veto a right-to-work bill, if she’s elected. That also drew applause from her audience.

Election day is Tuesday across Missouri.

Click here to listen to Governor Mike Parson speak to Missourinet’s Brian Hauswirth and other reporters at Columbia’s Emery Sapp and Sons on October 27, 2020:

Click here to listen to Brian Hauswirth’s interview with Missouri Auditor Nicole Galloway, on October 29, 2020 in Columbia:

Rural hospital closings getting attention from both candidates in southern Missouri congressional race (AUDIO)

October 28, 2020 By Brian Hauswirth

Health care has emerged as a major issue in southern Missouri’s Eighth Congressional district race between U.S. Rep. Jason Smith (R-Salem) and his Democratic challenger Kathy Ellis.

The sprawling district includes 30 southern Missouri counties and about 20,000 square miles. It stretches from Jefferson County, south of St. Louis, all the way to the Bootheel. It also includes southern Missouri towns like West Plains, Ava, and St. James. The district hasn’t sent a Democrat to Washington since Congressman Bill Burlison, who served from 1969 to 1981.

The Eighth Congressional district has seen five hospital closings since 2016:

** Parkland Health Center in Farmington (2016)
** Southeast Health Center of Reynolds County in Ellington (2016)
** Southeast Health Center of Ripley County in Doniphan (2018)
** Twin Rivers Regional Medical Center in Kennett (2018)
** Black River Medical Center in Poplar Bluff (2019)

Ellis, a social worker who lives in Festus, supports Medicaid expansion and says federally qualified health centers must be expanded in southeast Missouri.

“So that they’re delivering primary care, behavioral health, dental, OBGYN, everything that the area needs,” Ellis says.

As for Congressman Smith, he says Medicaid expansion is a state issue. He has described the hospital closings as “unacceptable” several times, during interviews with Missourinet. He notes that people die when hospitals close, noting that rural hospital closures are associated with an increase in an area’s mortality rate.

But Smith says attention hasn’t been given to the hospitals he’s worked to save, like the Iron County Medical Center in Pilot Knob. Smith tells Missourinet the facility was days away from closing, and that he and U.S. Sen. Roy Blunt (R) worked with the hospital administrator to keep it open.

Smith also says that when the COVID-19 pandemic hit, he immediately got hospital administrators, local health clinics and doctors on the phone, and brought their needs to the president. He notes he successfully urged the Trump Administration this year to reverse its earlier rule requiring telehealth to have audio and video, saying that’s been huge for the district, which has major issues with lack of rural broadband and cell service.

“And so working with the president (Donald Trump), I was able to get him to do an executive order to rescind it, that they could do telehealth by just audio. It didn’t have to be audio and visual,” Smith says.

Congressman Smith also filed legislation in July called the “Saving Rural Hospitals from Closure Act,” which would keep rural hospitals open by allowing the HHS Secretary to give hospitals flexibility to remain financially viable.

The two candidates agree that access to quality health care is critical in southeast Missouri, and that the district needs every hospital and rural clinic in it.

They also agree on the need for improved rural broadband in the district.

As for Ms. Ellis, she reiterates that health care is the top priority for residents in the district. She notes it’s impoverished and that some southeast Missourians must drive two hours for health care.

“We have huge infant/mother mortality rates in the Bootheel and we have fully one-third of the 16 counties surrounding the Bootheel where children don’t have enough to eat on the weekends,” says Ellis.

She says her priorities are the priorities of district residents, and that it’s time to have a representative who listens to the people.

During her interview with Missourinet, she notes that many southeast Missouri Republicans have run unopposed for state legislative seats during recent years.

She says there’s not been a lot of energy from the Missouri Democratic Party, for southeast Missouri and other rural areas. She says that’s happened around the nation as well.

But Ellis emphasizes that elections are won and lost in rural areas, and that Democrats must focus on rural America. She says winning can take multiple election cycles, and says young voters in her district are energized.

Ellis put 75,000 miles on her car in 2018, when she faced Smith. Smith won with about 73 percent of the vote, getting 194,042 votes to Ellis’ 66,151 votes.

Congressman Smith describes the district as “God’s Country.” It includes the Mississippi Delta and the Ozark Hills. He says his priority is to represent his constituents.

“That is to make sure our rural Missouri values has a strong voice and is represented in Washington D.C. Those values include limited government, freedom, lower taxes,” says Smith.

Smith says the tax cut signed by President Trump should be made permanent, along with doubling the child tax credit.

He also says the 2020 election is not just about the next two or four years, it’s about the next 50 years.

Click here to listen to Brian Hauswirth’s full interview with U.S. Rep. Jason Smith, R-Salem, which was recorded on October 26, 2020:

Click here to listen to Brian Hauswirth’s full interview with Democrat Kathy Ellis of Festus, which was recorded on October 26, 2020: