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Senate passes FRA reauthorization following lengthy debates

   

JEFFERSON CITY, Mo. — After some back-and-forth over the past few weeks, the Senate eventually passed legislation reauthorizing the state’s federal reimbursement allowance (FRA) Monday.

Republican Sen. Dan Hegeman’s SB 29 extended the sunset for the FRA program for one year, until September 2020. It initially included the addition of managed care to the program — which he said would bring down an additional approximate $20 million in federal Medicaid dollars — but it was eliminated after members of the Conservative Caucus complained.

The Senate passed the legislation Monday evening in a 33-1 vote. Sen. David Sater decried the lack of managed care included with the bill and said he wished the sunset was extended longer than just one year.

Last week, the Senate debated the bill overnight with Democrats filibustering a provision that would have added work requirements for those who are enrolled in the state’s Medicaid program and pushing for the expansion of Medicaid in Missouri. 

Sen. Brian Williams stressed the importance of protecting the “relationship we have with the federal government” through the FRA program — and the addition of work requirements could have possibly derailed the reauthorization.

“FRA is not a new program, and it’s something that has allowed us to pull from as a major source of revenue for the state. When it comes to just making sure we have funding for the state Medicaid program, I think it’s imperative we support it,” Williams told The Missouri Times.

“When it comes to the work requirements, I think it can become an obstacle for Missourians — not to have access to Medicaid or quality healthcare in general,” he continued. “That’s something I think we have to be conscious of when we think about whether or not we want Missouri to be healthy. I think it was an amendment with intentions to become a roadblock for Missourians.”

Originally, the bill added managed care to the FRA program, which caused consternation among some lawmakers, particularly those in the Conservative Caucus. However, it was ultimately removed.

Sen. Cindy O’Laughlin said even though the additional tax would bring in extra money, there would be “no additional benefit to the individuals” who would have to pay the extra money.

“We have to recognize that the money coming into the state is hard-earned money, and we need to honor and respect that by doing the hard work necessary to have a full comprehension of our spending commitment and a good plan that does not render the average working Missourian poorer,” the Republican senator previously told The Missouri Times. “We’re not looking ahead and taking everything into consideration.”

“I do think a conversation at some point has to be held considering how much we depend on federal funding.”

Last week, O’Laughlin applauded the elimination of the “additional tax” since the reauthorization needed to happen.

“I do think a conversation at some point has to be held considering how much we depend on federal funding,” she said.

The FRA program isn’t new; in fact, it began more than two decades ago in 1991 before the provider tax became law in the state a year later. The Missouri Hospital Association touts the program as a “major source of revenue to the state” and a “major funding stream for MO HealthNet,” the state’s Medicaid program.

The program taxes providers under its umbrella for the state’s Medicaid program. That money, in turn, is then matched by federal dollars at a higher rate, reimbursing the providers and leaving the state with extra money.

Under the program’s purview are: ground ambulances, nursing facilities, hospitals, pharmacies, and facilities for the intellectually disabled.

Inside the Senate’s FRA reauthorization battle