MOScout Daily Update: Omnibus Season - Senate Debate Prior Authorization - Smith Punches Hospitals - MOSERS Questions and more…
Omnibus Season
With just over two weeks remaining, we’re entering the session’s “omnibus season.” Every bill on the Senate floor is now viewed for its potential as a vehicle for legislative items that lawmakers want to try to get across the finish line.
Prior Authorization Hits Senate Floor
Yesterday the Senate tackled Sen. Mike Bernskoetter’s SB 841. Several senators attached or attempted to attach healthcare provisions. One of them was the high-profile “prior authorization” issue, brought forth by Sen. Mike Henderson. It was a slightly different version from Rep. Melanie Stinnett’s which the Senate Insurance Committee heard a few weeks ago.
In that hearing, insurers and hospitals faced off the potential costs of implements – or not implementing – the policy.
Talking points from the committee…
· The hospitals: “Just for the edification of the committee, we hire at BJC almost 300 people to do nothing but this process of prior authorization… Our hospital consistently is approved either through appeal or immediately, somewhere between ninety four and ninety six percent of the time depending on who they are.”
· Insurers: “[Prior authorization] blew a hole in their state, public employee health plan budget, when they authorized a 90% threshold, did not exclude pharmaceuticals and within one year were exposed to an additional $52,500,000 related to GLP-one drug costs.”
After Sen. Mary Elizabeth Coleman added an amendment carving out Medicaid, Henderson withdrew the prior authorization language. But the issue is still be negotiated between insurance and hospitals and will likely be back.
· Bernskoetter’s bill was laid over. It’s expected the Senate will return to the healthcare omnibus next week – which means there’s still time for legislators and lobbyists to swing by Bernsy’s office if they’re hoping to get their healthcare stuff done this year.
Meanwhile
Congressman Jason Smith threw some punches at hospitals yesterday in a Ways and Means Committee hearing.
· Politico: “Our local hospitals and physicians have been replaced by mega-corporations that put quarterly earnings over quality care,” Smith said at the hearing. “When hospitals have no competition, it’s no wonder that the sky seems to be the limit for prices.”
· The Hill: “Our communities are better off with hospitals in them, but large health systems have taken advantage of that reality…Simply put, hospitals are charging an insane amount for care.”
Demin Day
Press release: Governor Mike Kehoe has ordered the Missouri State Capitol dome to shine teal beginning at sunrise on Wednesday, April 29, 2026, until sunrise on Thursday, April 30, 2026, in recognition of the 25th anniversary of Sexual Assault Awareness Month…
Denim Day is observed nationwide as a visible symbol of solidarity with survivors, inspired by a 1990s legal case in which an Italian court overturned a rape conviction because the victim wore tight jeans. Supporters are encouraged to wear denim to challenge misconceptions around sexual violence and to spark conversation about consent, respect, and community responsibility.
· In Missouri, it is estimated that 1 in 3 women and 1 in 7 men experience sexual violence in their lifetime.
Senate 10: Deering Kickoff
Mike Deering had a good crowd for his kickoff last night. One MOScouter said it “looked like a Lincoln Days event but with a much larger crowd.” Another noted the politico-heavy attendance: “A huge chunk of the capital attended.”
Those names included three statewides, Governor Mike Kehoe, Treasurer Vivek Malek, and Secretary of State Denny Hoskins, as well as Sens. Jason Bean and Travis Fitzwater, Reps. Kent Haden, Jim Schulte, Doyle Justus, and Wendy Hausman, and former electeds Mike Parson and Blaine Luetkemeyer.
· “He had a crew to video his remarks... The audio seemed rough, so I’m not sure how much of the video they will be able to use.”
MOSERS Under Fire?
The Joint Committee on Public Employee Retirement yesterday focused on MOSERS (Missouri State Employees’ Retirement System). The system covers over 100,000 current and retired Missouri state employees, and there’s concern because it’s only 55% funded and has asked for increasing payments from general revenue.
Among the areas of inquiry…
· MOSERS has underperformed peers. According to testimony, the fund’s asset-allocation choices were the main reason it lagged – largely because it was too light on stocks during a significant stock-market run.
· MOSERS sued Catalyst Capital alleging breach of fiduciary duty, breach of contract and fraud, but the case has had adverse rulings. It’s now on appeal, but it’s already cost MOSERS about $20 million in legal fees.
Sen. Doug Beck defended MOSERS Executive Director Abby Spieler. Referencing “rumors,” he said it’s wrong to blame people for decisions made 20 years ago: “I hear, there’s rumors and all these other things. Whatever… we make decisions based on the best information that we have. We trust people. Abby’s been fantastic. I would go to war for her. She’s been great. She’s one of the best leaders I’ve ever seen… But I think to hold us accountable for twenty years ago is just crazy at this point.”
Ballot Issues to August?
The mighty Jason Rosenbaum looks at the possibility that Governor Mike Kehoe will move ballot issues to the August primary election. Read it here.
Missouri Gov. Mike Kehoe is not ruling out putting statewide ballot initiatives in the August primary instead of the November general election.
As of Tuesday, Missourians are slated to vote on five measures in November. They include proposals to:
· Repeal constitutional protections for abortion rights that voters backed in 2024.
· Allow the legislature to expand sales and use taxes as a way to eliminate the state’s income tax.
· Make it much harder for constitutional amendments put on the ballot through initiative petition to pass.
· Renew a sales tax that helps pay for state parks and state conservation efforts.
· Make the Jackson County assessor an elected position.
Kehoe has until May 22 to move any of those ballot items. While it is possible for him to move it to any date, including a special election, governors who have used this power typically shifted proposed ballot measures to the August primary, which usually has lower turnout.
eMailbag on Cupps
As quirky as Rep. Scott Cupps can be, he has a great point about parking!
Help Wanted
Department of Elementary and Secondary Education seeks Legal Counsel - Governmental Affairs.Provide legal advice to department divisions and offices, including the Office of Childhood regarding the development, implementation, interpretation and/or application of childhood related law, regulation, policy, and procedures; Assist the Chief Counsel in advising the Department of Elementary and Secondary Education on all significant activity regarding federal and state statutes, legislation, regulation, proposed legislation of interest to the department; Represent the department at administrative hearings related to department programs.See the posting here.
$5K+ Contributions
MO Majority PAC LLC - $25,000 from Protection Plus LLC.
Her Health, Her Future PAC - $25,000 from John Conoyer.
We Are Missouri - $10,000 from Missouri AFL-CIO.
Lobbyist Registrations
Sana Naqvi added Families Against Mandatory Minimums.
Happy Birthdays
Happy birthdays to Rep. Stephanie Hein, Brad Bates, and Belinda Harris.