Missouri risks Medicaid funding over contraceptive fight

JEFFERSON CITY, Mo. -- Missouri is at risk of losing $4.5 billion in tax revenue and federal funding for Medicaid because of a fight between lawmakers over contraceptives.

At issue is a state tax on hospitals, doctors and other health care providers used to draw down billions of dollars in federal funding for the government health insurance program, which covers children, low-income adults and people with disabilities.

The Republican-led Legislature adjourned last month without reauthorizing the tax after fighting over whether to include a ban on Medicaid coverage for "any drug or device approved by the federal Food and Drug Administration that may cause the destruction of or prevent the implantation of, an unborn child."

Federal law requires Medicaid programs cover family planning.

The tax expires Sept. 30.

Republican Gov. Mike Parson has said he'll start cutting the state budget if lawmakers don't reup the tax by the start of the next fiscal year, July 1.

He's expected to call lawmakers back to the Capitol to work out an agreement soon.

"You absolutely can't wait until Sept. 30 and expect to get it done. It won't happen," Parson told reporters Tuesday. "So July 1, there will be withholds -- there is no other option for us."

Parson said his administration has been meeting with lawmakers for days trying to hammer out a solution and added he'll push to work on weekends if necessary to get the tax renewal passed.

Parson said Tuesday he's open to considering limits on certain medications in the tax renewal bill as long as it doesn't put Missouri at risk of losing out on federal Medicaid funding.

The tax provides a significant chunk of the state's Medicaid budget. Missouri planned on bringing in about $1.6 billion directly from the tax in the upcoming fiscal year, which begins July 1, according to an analysis by the Missouri Budget Project. That would draw down another roughly $2.9 billion in federal funding.

The not-for-profit Missouri Budget Project analyzes state financial issues with an eye toward their impact on low-income residents.

Missouri Budget Project president and CEO Amy Blouin said in a statement losing the tax and its federal drawdown would have a "domino effect, destabilizing the entire state budget."

"The consequences of failing to renew Missouri's provider taxes would be dire, affecting services far beyond Medicaid, and they would be felt by Missourians in every community across our state," Blouin said.

At least three other states have adopted similar provisions limiting access to emergency contraception, according to Guttmacher Institute, a research group that supports abortion rights.

Texas doesn't provide emergency contraception in the state's family planning program, and Arkansas and North Carolina exclude it from the states' contraceptive coverage mandates.

Missouri's Democratic House Campaign Committee Chairman Peter Merideth, a St. Louis representative, in a statement said Republicans' proposed medication ban in the bill would "take away access to birth control for thousands of Missourians."

"Extreme right-wing Republicans are threatening the very existence of Missouri's Medicaid system, holding the third largest source of state revenue hostage over new partisan language that will have devastating, real-world consequences," he said.