More Medicaid for moms gets nod after abortion deal

JEFFERSON CITY, Mo. — New mothers in Missouri could gain Medicaid health care coverage for up to a year under legislation passed Thursday by the state Senate, part of a national movement of expanded care that began during the coronavirus pandemic.

The bill also would extend coverage to those who have miscarriages or abortions necessary to save their lives. Senators passed the legislation only after inserting wording intended to exclude women who get elective abortions. Missouri has banned most abortions since June.

The legislation seeks to add Missouri to a growing list of 28 states and the District of Columbia that have extended Medicaid health care coverage from the typical 60 days up to 12 months after a woman gives birth. The option was made possible under a pandemic relief law signed by President Joe Biden in 2021.

Supporters say it's an important means of keeping both the mother and infant healthy, and of cutting down on mortality rates among new moms.

The Missouri bill, which passed 27-4, now goes to the House for consideration, where a committee endorsed a different version earlier this week. The House bill contains no wording regarding abortions. Both legislative chambers must pass the same version before their session ends in mid-May for a bill to go to the governor for approval.

Democratic Sen. Tracy McCreery of St. Louis County, who voted against the Senate bill, called the abortion-related exclusion a "poison pill" that could jeopardize the necessary approval from the federal Centers for Medicare & Medicaid Services.

"It really is a form of government policing and surveillance over low-income women, and it is unacceptable," McCreery said after the vote.

The Senate bill states the 12 months of Medicaid coverage begins "on the last day of the woman's pregnancy." It doesn't specifically mention "abortion" but instead says "no woman who knowingly receives services that are in violation of state law shall be eligible."

Senate President Pro Tem Caleb Rowden, a Columbia Republican, said he didn't believe the wording was necessary. But he said some Republicans wanted it to prevent Missouri residents who undergo abortions in other states from qualifying for the extended 12 months of Medicaid.

Missouri's ban on most abortions took effect in June, moments after the U.S. Supreme Court overruled its 1973 Roe v. Wade decision establishing the nationwide right to abortion.

More than 4,500 women are expected to become newly eligible for Medicaid coverage under the legislation, according to the state Department of Social Services. The expansion is projected to cost more than $30 million annually in federal and state funds by the 2025 fiscal year.

Supporters include Republican Senate Majority Leader Cindy O'Laughlin of Shelbina.

"Prior to now, I would have probably said, 'I don't want to expand welfare,'" O'Laughlin told reporters. But she added: "If you have a new mom, and she does not have adequate health care, then it really stands to reason that the person that might suffer the most would be the child or the children."