Lately, there has been a significant amount of coverage on the failure of the Senate to pass a voluntary tax paid by hospitals that allows us to draw down a large federal match referred to as the Federal Reimbursement Allowance (FRA). This tax generates more than $1 billion, and the match adds another $2 billion.
Established in the 90s, the FRA has had wide support from providers that pay the tax, and it allows us to maximize the federal dollars we use to fund Medicaid. It has been handily renewed on an annual basis by the General Assembly because it’s the major revenue stream that funds our current Medicaid program. Since we do not have to allocate nearly as much money from general revenue into Medicaid as we would without the FRA, it frees up that spending to go toward other important state services.
But for the first time since its creation in 1992, the General Assembly failed to extend the FRA.
This year, two Conservative Caucus members in the Missouri Senate upped the ante by adding an amendment to prohibit funding abortion with federal dollars (which is already illegal) and prohibiting funding a wide range of forms of birth control.
Setting a prohibition on state funding of birth control violates federal law. When this amendment made it onto a version of the bill in the Senate, Senate leadership withdrew the bill because passing that version of the bill risked Missouri losing all of its federal match money for Medicaid.
By conflating Medicaid and abortion, they have forced legislators into a false choice between funding health care by maximizing our resources and jeopardizing Missouri’s budget. The governor will likely need to start making drastic cuts to other state programs — like education, transportation, and economic development — to make up for the Medicaid shortfall if we do not have an FRA.
But we can still fix this mess. This is the ante that’s on the table: The deadline to reauthorize the FRA is Oct. 1 as the current authorization expires Sept. 30.
Gov. Mike Parson has a chance to end this lunacy both within his power as governor and as a leader of his party in this state. As governor, he can call a narrowly-tailored special session to pass a clean version of the FRA as Missouri General Assemblies have done for nearly three decades. And as a leader of Missouri Republicans, he can denounce the shameful, indecent behavior on the part of extremists within his party who have chosen to gamble the lives and livelihoods of Missourians to promote themselves with anti-birth control rhetoric.
He must stop this reckless and disgraceful high-stakes poker game with our tax dollars because the consequences of this “winner take all” dynamic could be catastrophic.
Governor, it’s time to put the cards on the table and call all players back to session to end this reckless and dangerous game with our tax dollars. There is time to get this tax renewed with a simple majority — if you act now, in time for the Oct. 1 deadline.
The stakes are too high to entertain any other outcome.
Rep. Ingrid Burnett is a Democrat who represents HD 19 in Jackson County. She is the Minority Caucus chair.