House sends bill to governor renewing taxes critical to funding Missouri Medicaid

The Missouri House chamber during debate on March 12, 2023 (Tim Bommel/Missouri House Communications).

A set of medical provider taxes that fund a large portion of Missouri’s Medicaid program won quick approval Wednesday in the House, two weeks after it took 41 hours for the bill to pass in the state Senate.

The controversies that stalled the bill in the Senate received scant attention during Wednesday’s debate, except for being cited as an example of what to avoid in the future. The bill taxes hospitals, pharmacies, nursing homes and ambulance services to raise about $1.3 billion for Medicaid services and leverage nearly $3 billion in federal matching funds for the $17 billion program.

“This shouldn’t be used as a hostage in a terrorist negotiation,” said House Minority Leader Crystal Quade, a Springfield Democrat.

The renewal bill extends the taxes for five years, one of the longest sunsets since the tax was first enacted in 1991. Since then, the levies have been renewed 17 times, most recently for three years in 2021 during a special session.

For the second time, renewal of the taxes became enmeshed in the debates over abortion and whether Planned Parenthood can receive reimbursements for services covered by Medicaid. Members of the Missouri Freedom Caucus tried, and failed, to delay action on the provider taxes until a bill targeting Planned Parenthood was signed by Gov. Mike Parson and a proposal making it harder to pass a constitutional amendment is finished and set for a vote later this year.

Parson did sign the Planned Parenthood bill, but almost a week after the filibuster ended. And the record set by the Freedom Caucus, by holding the Senate floor for 41 hours, has been surpassed by Democrats this week as they block a vote on the constitutional majority changes.

As he asked for support, House Budget Committee Chairman Cody Smith, a Carthage Republican, said the bill’s importance to financing Medicaid was the only issue to concern members.

The taxes, he said, “have become an integral part” of the Medicaid program and renewal “is very critical” to balancing the $51.7 billion budget passed last week 

The debate and 136-16 vote took about five minutes. Quade said there was no controversy in the House on the bill. 

“Most of us…  absolutely, desperately want this passed today,” she said.

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