Hello Missouri Members! It’s Session “halftime” for the General Assembly. And just in time! A Capitol denizen once quipped, “the legislature’s “spring break” isn’t for family time, it’s to keep legislators from killing one another.” An exaggeration for sure, but our policymakers can use a cooling off period. Things have been testy in the runup to “spring break.”
While spring break is seldom a perfect Session midpoint, it always signals a shift in focus. In the “second half” the House considers mostly Senate-passed bills while the Senate focuses on House bills. That will be less true this year, however, as the upper chamber has passed but ten bills while the House – working feverishly before spring break – achieved its goal of passing more than 100. We anticipate a major legislative logjam on the Senate floor.
Like sports teams do at halftime, we use Session “halftime” to assess where we are on policy initiatives and recalibrate to win in the second half, which frames my perspective mid-March.
Budget Bills for SNF & HCBS Medicaid Reimbursement
We’re in a good place, but we can’t get complacent. The State is confronting a huge budget deficit, making budget cuts the order of the day. To our mild surprise and great pleasure, the Governor’s budget blueprint held our SNF and HCBS rates constant, allowed higher utilization, and increased funding for SNF value-based payments. Accordingly, on “Advocacy Day” we lobbied legislators to support the Governor’s recommendations and oppose cuts. We currently have what we asked for! The House Budget Committee passed SNF (HB 11) and HCBS (HB 10) budget bills with the Governor’s recommendations intact. The full House is highly likely to pass each bill “as is” after spring break. In the annual budget war, this is a battle victory. We must now protect our “win” in the Senate Appropriations Committee, on the Senate floor, and in any House/Senate Conference convened for budget compromises. There’s work ahead, but we’re in a decent place for FY 2027 SNF and HCBS Medicaid reimbursement. Would we have liked rebasing or rate increases? Yes! Do we consider avoiding budget cuts “win”? You betcha!
Practice Rights Expansion for APRNs
On this topic, we’re adrift looking for a paddle! Our LA MO “lobbyists for a day” urged support for several bills that would ultimately grant nurse practitioners full practice rights in Missouri (rights APRNs enjoy in the majority of states). At a recent hearing, I testified in support of the Senate bills alongside other influential organizations. So far there’s been no Committee vote on the bi-partisan initiative – not a good sign! And the House is yet to schedule hearings on companion legislation. Absent a momentum shift, it’s again looking like APRN practice right expansion will not make it to the Governor’s desk this year.
Property Tax Exemption for Non-Profit, 501(c)(3)s
On Advocacy Day, LA MO advocates tested the waters on this proposal. Historically, local tax assessors did not assess property tax on charitable organizations. On Advocacy Day, legislator reactions to an exemption were mostly non-committal. Legislators eschew initiatives that reduce revenue for their constituent counties or that make the legislators appear supportive of one constituency over another. The LA MO Board discussed our unexpected opportunity to avoid property taxes on 501(c)(3) providers and raised concerns. Without aggressive, strong support, this initiative will not advance. If the comprehensive property tax reforms (to which our proposal was positioned to be added) do not pass this year – and they may not in the current fiscal environment! – we may have another “bite at the apple” later. We’ll tee up the issue for member consideration and prepare.
Health Service Pre-Authorization Reform
LA MO provider members find payor pre-authorizations a pain! HB 3010 seeks to fairly balance and streamline the process for health plan sponsors, participants, payors, and healthcare providers. Your LA MO Board applauded Representative Melanie Stinnett’s reform proposals when she overviewed HB 3010 at a recent meeting. Last week, HB 3010 passed the House with a huge vote. The bill has momentum going into the “2nd half” in the Senate – where politics and process challenges await. Regardless, we will work to advance HB 3010 and incorporate changes our members require.
Members, those are Bill’s “spring break” “halftime” perspectives.
Yours in service,
