Healthcare (Medicaid)

in committee · Missouri · House May 15, 2026

HB 2635: Requires the department of social services to submit a state plan amendment or seek any necessary waivers requesting approval for MO HealthNet coverage of fertility treatments

This bill directs the Missouri Department of Social Services to submit a state plan amendment or seek federal waivers to allow MO HealthNet, the state's Medicaid program, to cover fertility treatments for eligible participants. The legislation specifically targets individuals enrolled in MO HealthNet who may need assisted reproductive services, requiring the department to formally request approval from the Centers for Medicare and Medicaid Services to expand coverage. By mandating this administrative process, the bill ensures that any new fertility treatment benefits comply with federal Medicaid regulations while enabling the state to pursue coverage options for reproductive health services. The measure does not establish new coverage on its own but creates a pathway for the department to seek the necessary federal authorization to include these treatments in the program.

Topics ✓ HealthcareSupports HealthcareBill seeks to expand Medicaid coverage for fertility treatments, improving patient access to reproductive healthcare services.92% confidence

Sub-Topics Medicaid Medicare Women's Health

Track

in committee · Missouri · House May 15, 2026

HB 1952: Requires insurance coverage for childbirth education classes

This bill requires Missouri's MO HealthNet program to cover childbirth education classes for eligible low-income individuals. It achieves this by updating existing state health insurance statutes to include payment for prenatal and childbirth preparation courses as a covered benefit. The changes directly impact pregnant women enrolled in the state's Medicaid program by ensuring their insurance plans pay for these educational services. The legislation modifies current payment rules to explicitly allow reimbursement for these classes without adding new funding requirements.

Topics ✓ EducationSupports EducationBill expands educational access by requiring insurance coverage for childbirth education classes, supporting prenatal education for low-income individuals.75% confidence ✓ HealthcareSupports HealthcareBill expands Medicaid coverage to include childbirth education classes, improving access to prenatal care and health education for low-income pregnant women.95% confidence

Sub-Topics Insurance Medicaid Women's Health

Track

in committee · Missouri · House May 15, 2026

HB 3168: Creates provisions relating to insurance coverage of doula services

HB 3168 requires Missouri health insurance plans to cover doula services starting January 1, 2027. It mandates coverage for pregnant women enrolled in MO HealthNet (Missouri's Medicaid program), including up to 16 support sessions (6 base sessions plus 10 additional if needed) during pregnancy and the first year postpartum. The bill defines "doula services" as nonmedical birth support, including prenatal education, labor assistance, and postpartum care, and requires the Department of Health to establish registration criteria for doulas to qualify for reimbursement. It exempts supplemental policies like accident-only or Medicare supplement plans from this requirement. The bill is currently in committee after its first reading in February 2026.

Topics ✓ HealthcareSupports HealthcareMandates insurance coverage for doula services, expanding access to maternal care under Medicaid and nonmedical birth support, directly advancing healthcare coverage.95% confidence

Sub-Topics Insurance Medicaid Medicare

Track

in committee · Missouri · House May 15, 2026

HB 3169: Creates provisions relating to insurance coverage of doula services

HB 3169 requires Missouri's Medicaid program (MO HealthNet) to cover doula services for eligible pregnant women, including support during prenatal care, childbirth, and the postpartum year. It expands existing coverage by allowing doula attendance at scheduled cesarean sections and increasing covered support sessions from six to sixteen total. The bill also mandates that all private health insurance plans in Missouri must cover doula services starting January 1, 2027, with exceptions for supplemental policies like accident-only or short-term plans. This directly affects pregnant and postpartum individuals enrolled in MO HealthNet or private insurance, ensuring access to nonmedical support from trained doulas.

Topics ✓ HealthcareSupports HealthcareExpands Medicaid coverage to include doula services for pregnant women and mandates private insurance coverage starting 2027, directly increasing access to maternal healthcare services.95% confidence

Sub-Topics Insurance Medicaid Women's Health

Track

in committee · Missouri · Senate Apr 16, 2026

SB 1683: Modifies provisions relating to estates of persons receiving public benefits

SB 1683 modifies Missouri's Medicaid (MO HealthNet) rules to clarify how the state recovers costs paid for beneficiaries' injuries or illnesses. It requires beneficiaries, their representatives, or estates to notify MO HealthNet when pursuing third-party claims (like insurance or accident lawsuits), and mandates repayment of MO HealthNet benefits from settlement proceeds within 60 days. The bill establishes a 3-year window for submitting subrogation claims and a 6-year enforcement period, while prohibiting third parties from denying claims due to minor administrative errors. Failure to cooperate with recovery efforts may result in loss of MO HealthNet eligibility. The policy directly affects MO HealthNet beneficiaries, their estates, and liable third parties (e.g., insurers, hospitals).

Topics ✗ Budget & TaxesOpposes Budget & TaxesBill restricts estate recovery for Medicaid recipients, limiting state ability to recover funds and reducing fiscal accountability in budget management.75% confidence ✓ HealthcareSupports HealthcareClarifies Medicaid cost recovery to ensure program financial sustainability without restricting beneficiary access or benefits.85% confidence

Sub-Topics Long-Term Care Medicaid Substance Abuse

Track

in committee · Missouri · House May 15, 2026

HB 3382: Reestablishes the ticket to work health assurance program

HB 3382 reestablishes a state health assistance program for employed individuals with disabilities who meet specific income and asset criteria, directly affecting working people with disabilities who previously lost Medicaid coverage due to earnings. The bill allows medical assistance for those earning up to 250% of the federal poverty level (FPL), with premiums based on income brackets (4-6% of income), while excluding certain assets like medical savings accounts and retirement funds from eligibility calculations. Key provisions include requiring proof of Medicare/Social Security tax withholding for earned income, prioritizing employer-sponsored insurance when cost-effective, and mandating annual reports to the legislature on program participation. The program expires on August 28, 2032, and aligns with federal Ticket to Work Act requirements.

Topics ✓ Budget & TaxesSupports Budget & TaxesRestores state-funded Medicaid coverage for disabled workers via income-based premiums, directly increasing budget allocation for essential social services.90% confidence ✓ HealthcareSupports HealthcareReestablishes Medicaid coverage for employed disabled individuals previously denied assistance, expands access to medical aid up to 250% FPL, directly strengthens Medicaid/MO HEALTHNET program as per bill summary.95% confidence ✓ Labor & EmploymentSupports Labor & EmploymentReestablishes healthcare program preventing Medicaid loss for employed disabled individuals due to earnings, directly supporting workforce participation and benefits for vulnerable workers.95% confidence

Sub-Topics Income Tax Medicaid Medicare Tags People with Disabilities

Track

in committee · Missouri · House May 15, 2026

HJR 188: Proposes a constitutional amendment relating to MO HealthNet

HJR 188 proposes a constitutional amendment to expand Missouri's MO HealthNet eligibility. It would make individuals aged 19-65 with income at or below 133% of the federal poverty level automatically eligible for coverage, aligning with federal Medicaid standards. The amendment removes specific restrictions (subsections 5-6) that previously limited eligibility criteria for this group. If approved by voters, Missouri would need to update its state plan with federal authorities to implement this change. The bill requires voter approval before taking effect, as it amends the state constitution.

Topics ✓ HealthcareSupports HealthcareExpands MO HealthNet eligibility to 19-65 income-eligible residents, removing restrictions to align with federal Medicaid standards, increasing access to health coverage.95% confidence

Sub-Topics Medicaid

Track

in committee · Missouri · House May 15, 2026

HB 3360: Modifies provisions relating to MO HealthNet payments for nursing home services

HB 3360 changes how Missouri's MO HealthNet program pays nursing homes for Medicaid-covered services. It requires the state to seek a federal waiver to shift payments from volume-based (e.g., number of therapy sessions) to patient-driven payments based on residents' clinical needs. The bill also adds per diem payments tied to facility quality performance metrics and incentives for nursing assistant training and pay, while eliminating a prior payment adjustment for facilities with high rates of schizophrenia or bipolar disorder diagnoses among residents. These changes directly affect nursing homes participating in Missouri's Medicaid program for long-term care.

Topics ✓ HealthcareSupports HealthcareBill shifts MO HealthNet payments to quality-based metrics, incentivizes nursing staff training/pay, and eliminates prior payment adjustments for facilities with high rates of negative outcomes, improving care quality in nursing homes.95% confidence

Sub-Topics Long-Term Care Medicaid

Track

in committee · Missouri · House Apr 23, 2026

HCR 42: Expresses support for TrumpRx and encourages actions to prevent discriminatory insurance practices

HCR 42 is a non-binding resolution expressing Missouri's support for TrumpRx, a proposed online platform connecting patients with lower-cost prescription drugs. It urges health insurers and pharmacy benefit managers to count payments made through TrumpRx (and similar direct-purchasing platforms) toward patients' deductibles and out-of-pocket maximums. The resolution also asks Missouri's health department to assess the federal GENEROUS Model, which could help Medicaid programs access lower drug prices. This resolution does not change laws but recommends policy adjustments to ensure patients using direct-purchasing platforms receive full credit for their drug costs.

Topics ✓ HealthcareSupports HealthcareUrges insurers to count TrumpRx payments toward deductibles, improving patient access to lower-cost drugs and aligning with expanded coverage indicators.90% confidence

Sub-Topics Medicaid Prescription Drugs

Track

in committee · Missouri · Senate May 7, 2026

SB 1708: Repeals the expiration date for the Ticket to Work Health Assurance Program

SB 1708 makes Missouri's Ticket to Work Health Assurance Program permanent by removing its expiration date. This program helps working Missourians with disabilities maintain health coverage while earning income, without losing Medicaid benefits. It does not change existing eligibility rules, income limits, or premium calculations for participants - only extends the program indefinitely. The bill directly affects Missourians with disabilities who are employed and meet the program’s income and asset criteria.

Topics ✓ HealthcareSupports HealthcareExtends permanent health coverage for disabled workers, preventing loss of Medicaid benefits without altering eligibility or costs.95% confidence ✓ Labor & EmploymentSupports Labor & EmploymentBill extends permanent health coverage for working Missourians with disabilities, protecting their ability to maintain employment without losing Medicaid benefits, directly supporting employment stability and worker benefits.95% confidence

Sub-Topics Insurance Medicaid

Track