Missouri lawmakers pre-filed more than 500 bills over the past month that they plan to take up during the next legislative session, which begins on Jan. 7. Here’s a selection of bills related to health care that St. Louis Public Radio’s Health Desk will be keeping an eye on in 2015:
HB 282: Consumer Rate Review on Health Insurance Plans
The relatively unsexy field of insurance policy doesn’t always turn heads, but one bill that might have a shot would allow the Missouri Department of Insurance to review the cost and coverage details of proposed health insurance plans each year and publish their findings for consumers to see.
“We’re the only state in the union that doesn’t do this, and we do it for all the other forms of insurance,” said state Rep. Bill White, R-Joplin, the bill’s sponsor.
As it stands, the first time Missourians are able to look through health insurance plans is when they become available for purchase. Consumer advocacy groups say the lack of transparency allows insurance companies to raise rates or drop components of plans without publishing their justification for doing so or allowing public comment.
The St. Louis-based Consumers Council of Missouri filed a lawsuit against the U.S. Department of Health and Human Services over the summer in an attempt to force the federal government to release the information related to insurance plans sold on Healthcare.gov.
“Affordable Care Act aside, health care is getting more expensive and I think it’s important that people understand what their policies are costing and what is covered and not covered,” White said.
A similar resolution sponsored by White did not budge last year after it was referred to the Insurance Policy Committee, but he said he has higher hopes this year.
“I think we’ll get some good support on it. But the insurance companies weren’t real pleased with it,” White said.
SB 90: Third Time’s a Charm for Medicaid Expansion?
For the third time, state Sen. Paul LeVota, D-Independence, will try to expand Medicaid coverage in Missouri this legislative session. This bill extends eligibility to people who make up to 138 percent of the federal poverty level, or about $39,200 for a family of four. (For a state to receive federal money for Medicaid expansion, the law must cover people whose incomes are up to at least 133 percent.)
However, Republicans dominate both branches of the Missouri General Assembly, and the party has strongly opposed Medicaid expansion since it became an option for states under the Affordable Care Act.
“I know it’s a strange thing, where I continually have this bill and I will continue to talk about this issue, and I don’t feel confident that we’ll get it done. But if we don’t get it done this session, we’ll talk about it next session,” LeVota said.
LeVota admits that Missouri’s Medicaid program has its problems, including declining enrollment and longer wait times for people to sign up. He said he’d like to see it reformed, but still believes expansion should happen first.
Another version of Medicaid expansion filed by state Sen.-elect Jill Schupp, D-Creve Coeur, would offer an alternative package of Medicaid benefits to people whose incomes are below 133 percent of the federal poverty level. The MO HealthNet Oversight Committee would also be charged with conducting research to investigate health-related savings and revenue within the program.
Currently, MO HealthNet covers people whose incomes are below 18 percent of the federal poverty level, or about $4,300 a year for a family of four. The income requirements are higher for people who are pregnant, disabled or under the age of 18.
HB 130: Prescription Drug Monitoring Program Act
Proposed by state Rep. Holly Rehder, R-Sikeston, this law would create a statewide database that tracks who is receiving controlled substances, particularly those that are frequently abused. Supporters say prescription drug databases allow pharmacies to flag people receiving dangerous amounts of powerful painkillers or who may be re-selling their prescribed medications to other people.
Despite multiple attempts to pass a drug monitoring bill, Missouri remains the only state without such a program.
HB 40: Psychological Evaluations for Law Enforcement
Should police officers be regularly screened for PTSD and other mental health concerns? One bill filed by state Rep. Sharon Pace, D-Northwoods, would require officers to undergo mandatory psychological evaluations every three years at their own expense. It’s one of a series of bills filed by Pace and state Sen. Maria Chappelle-Nadal, D-University City, following protests in Ferguson.
HB 131: Father’s Consent Required for Abortion
Women seeking an abortion in Missouri are already required to undergo counseling, receive state-mandated materials about fetal development and wait 72 hours to terminate a pregnancy. The requirements also apply for medically induced abortions, which can be completed without surgery.
Now, state Rep. Rick Brattin, R-Harrisonville, hopes to add another requirement: Women must have the "written consent" of the fetus’ father. The pre-filed bill includes exceptions for women who become pregnant as a result of rape or incest or if the father is deceased.
Brattin sparked outrage in a December interview when he used the term "legitimate rape" when discussing these parameters with Mother Jones.
“So you couldn’t just go and say, ‘Oh yeah, I was raped,’ and get an abortion. It has to be legitimate rape,” Brattin told the reporter. “I’m just saying if there was a legitimate rape, you’re going to make a police report, just as if you were robbed.”
Only 32 percent of rapes are reported to police, according to the National Crime Victimization Survey. Less than a tenth of those reports lead to a felony conviction.
The bill does not specify how paternity would be proven in advance of the procedure, should there be a dispute. The earliest common type of paternity test cannot be completed until the eighth week of a pregnancy.
Another bill pre-filed by state Rep. Elijah Haar, R-Springfield, would deny parental custody to a father who the court finds tried to "coerce" the mother into obtaining an abortion. The law defines coercion as persuading "an unwilling person to do something by force or threats."
HJR15: A Bid For Legal Marijuana
A joint resolution sponsored by state Rep. Brandon Ellington, D-Kansas City, would regulate marijuana in a similar way that alcohol is regulated, making it legal for use by persons 21 and older. Possession and transfer of less than an ounce of marijuana would no longer be a criminal offense, nor would the cultivation of fewer than six plants for personal use. Driving under the influence of marijuana, however, would be prohibited.
The law also includes provisions to license businesses to grow and sell recreational marijuana.
Over the summer, Gov. Jay Nixon signed a limited medical marijuana bill into law. It allows industrial hemp to be grown so that the oil derived from the plant, called cannabidiol, can be prescribed to Missourians with intractable epilepsy, but only if they have not responded to at least three other treatments.
In contrast, Illinois is in the process of implementing a 2013 law to allow cannabidiol to be used to treat a host of ailments, including multiple sclerosis, traumatic brain injury and Parkinson’s disease. Epilepsy will be added to the list on the first of the year. The oil can also be recommended to a patient experiencing debilitating side effects from drugs treating cancer or HIV/AIDS. However, the Illinois Department of Agriculture has not yet submitted licenses to cultivation centers, so the drug is not yet available in the state.
