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Missouri House committee advances tax that funds bulk of state’s Medicaid program

The Missouri Capitol building on Wednesday, Dec. 3, 2024, in Jefferson City, Mo.
Tristen Rouse
St. Louis Public Radio
The Missouri Capitol building on Wednesday, Dec. 3, 2024, in Jefferson City, Mo.

With little fanfare, a Missouri House committee advanced a tax Monday that funds roughly a third of the state’s Medicaid program.

The House Budget Committee voted 27-0 to pass the Federal Reimbursement Allowance. It now moves to the full House.

Sen. Lincoln Hough, R-Springfield, is the sponsor of the bill and presented it to the House committee.

“I think you all are fairly aware of what this bill is and the necessity of about a third of our MO HealthNet budget being derived from these reimbursements from the feds,” Hough said.

Rep. Ingrid Burnett, D-Kansas City, was the only representative to inquire about the bill in committee.

“I'm very relieved that we're bringing this up to the table now and getting it done,” Burnett said.

The allowance is a tax on state health care providers like hospitals, ambulance districts and pharmacies. That tax is then reimbursed by the federal government on a greater scale.

Right now, the tax is set to expire at the end of September if it is not reauthorized this session. The bill being considered would extend the tax until September 2029.

The last time the Federal Reimbursement Allowance was up for reauthorization in 2021, it took a special session to pass it.

This year, the tax’s passage again looked daunting due to a filibuster from a faction of Senate Republicans.

Those senators held the floor for more than 40 hours a couple of weeks ago to advocate for the Senate to first pass an amendment that, if approved by voters, would make it harder to amend the constitution.

However, the Federal Reimbursement Allowance was ultimately passed by the Senate without that demand being met.

The road to pass the tax in the House appears smoother. The House Budget Committee both heard the bill and passed it Monday afternoon.

The whole House could vote on it as early as Wednesday.

House Majority Floor Leader Jon Patterson, R-Lee’s Summit, said that whenever the House is able to take up the bill and pass it on the floor, it will.

“If you recall at the beginning of the year, that was one of the top priorities, making sure that our Medicaid program is funded,” Patterson said.

Missouri lawmakers have until 6 p.m. Friday to pass any more legislation before adjourning.

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Sarah Kellogg is a first year graduate student at the University of Missouri studying public affairs reporting. She spent her undergraduate days as a radio/television major and reported for KBIA. In addition to reporting shifts, Sarah also hosted KBIA’s weekly education show Exam, was an afternoon newscaster and worked on the True/False podcast. Growing up, Sarah listened to episodes of Wait Wait...Don’t Tell Me! with her parents during long car rides. It’s safe to say she was destined to end up in public radio.