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Inside the FRA reauthorization negotiations

JEFFERSON CITY, Mo. — Most Republican senators met with Gov. Mike Parson for nearly an hour Tuesday afternoon to see if they could coalesce on an FRA reauthorization plan. And the consensus following the discussion is that they’ve inched closer to a deal with a special session in the works possibly as soon as next week. 

Nearly every Republican senator attended the meeting with one calling in remotely. On the table, in particular, were three components to the FRA debate: the length of reauthorization; language prohibiting Medicaid funding for abortion providers and affiliates; and restricting the program from covering family planning services that include certain abortifacients and drugs like Plan B or IUDs when used to induce an abortion. 

Sens. Paul Wieland and Bob Onder were some of the most vociferous advocates for attaching pro-life language to the FRA reauthorization during session. However, the legislative session ended without reauthorizing the program which is set to expire on Sept. 30 and brings about $4 billion to the state. 

Following the meeting, multiple senators said they were closer to reaching a deal on reauthorization and could be ready for a special session to be called as early as next week. 

Onder said lawmakers are closer to a deal on the drug language than funding abortion providers. 

“Our FRA bill opens up Medicaid funding statutes and is the perfect mechanism to do what the body — the House and the Senate — has voted overwhelming to do in previous years [with budget bills] which is to say abortion providers and their affiliates cannot receive state Medicaid dollars,” Onder said. 

Sources said the Governor’s Office wanted the reauthorization to be set to sunset in five years, but lawmakers expect to whittle that down possibly during floor debate. 

“I don’t think it’s going to happen,” one senator who attended the meeting said of the five-year sunset. “The FRA is a big deal, and it’s something Republicans use to leverage in negotiations with Democrats over other things. Why would you give up the biggest bargaining chip in negotiations in the Senate? 

The language worked on yesterday, first reported by The Missouri Times, says: 

Family planning as defined by federal rules and regulations; provided that such family planning services shall not include abortions or any abortifacient drug or device unless such abortions are certified in writing by a physician to the MO HealthNet agency that, in the physician’s professional judgment, the life of the mother would be endangered if the fetus were carried to term. 

As used in this subdivision, “abortifacient drug or device” includes: mifepristone in a regimen; misoprostol alone when used to induce an abortion; levonorgestrel (Plan B); ulipristal acetate (ella) or other progesterone antagonists; an intrauterine device (IUD) or a manual vacuum aspirator (MVA) when used to induce an abortion; or any other drug or device approved by the federal Food and Drug Administration that is intended to cause the destruction of an unborn child, as defined in section 188.015;

One Republican senator pontificated on whether Democrats could derail the reauthorization if the pro-life language was added: “I don’t think Democrats are going to be responsible for killing the bill. We, Republicans, are holding all the cards here.” 

“I’ll be ready for a special session,” Onder said. “It would definitely be ideal if we could work out this abortion provider funding language before we get to special session.” 

But Senate Minority Leader John Rizzo said: “We have not seen the final special session language yet, but clearly, more than $4 billion in health care funding now hangs in the balance because a group of Republicans wants to block women on Medicaid from accessing birth control.”

House members reiterated over the weekend they prefer to work with a clean FRA bill. Rep. Peter Merideth, chair of the House Democratic Campaign Committee, called the language “abhorrent and dangerous.”

“Democrats will do everything in our power to ensure that access to birth control and reproductive healthcare remains available to every Missourian, while also fighting to fully fund our Medicaid program,” Merideth said. 

Kelli Jones, a spokeswoman for the governor, said Wednesday afternoon “nothing at this time is confirmed” regarding a special session timeline.

Failure to reauthorize the FRA could result in a loss of up to $5.7 billion in federal funding — which includes money from the American Rescue Plan — and could mean budget cuts to education or social services, according to an analysis from the Missouri Budget Project.

“The state Medicaid provider tax is a critical component of Missouri’s revenue structure and serves as a building block upon which all public services, including health and education, are funded,” Missouri Budget Project President and CEO Amy Blouin said. “The loss of this revenue source would create 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.”