MO lawmakers turn to improving child care, maternal health post-Roe – News-Leader

The majority of Missouri lawmakers will return to the Capitol in January with a longtime policy goal fulfilled — the end of legal abortion. Now, bills pre-filed for the 2023 session indicate a desire among several of them to improve child care and safeguard the health of new mothers who, barring medical emergencies, must carry their pregnancies to term.
In both chambers and on both sides of the aisle, legislation has been proposed that would extend Medicaid coverage for new mothers — allowing the low-income health care program to insure them for a year after birth, up from the current 60 days. It’s among the priorities that advocates say need to be addressed to improve health outcomes in the wake of overturning Roe v. Wade and instituting a ban on abortion in Missouri.
“Taking care of Missouri’s most vulnerable population is an issue we should all be able to support,” said Sen. Elaine Gannon, a De Soto Republican who is sponsoring a version of the bill. “I look forward to getting the bill across the finish line this year and taking care of Missouri’s mothers and their children.”
Other sponsors of the legislation include Sen.-elect Tracy McCreery, a St. Louis Democrat; and Rep. Jonathan Patterson, a Lee’s Summit Republican who will serve as House majority leader — indicating a bipartisan desire to push the legislation during the coming session. Though women in the Senate attempted to advance the measure in 2022, it failed to get past a group of conservative male Republicans and was eventually scrapped.
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“We’re seeing conversation in that space, which I’m excited about,” said House Minority Leader Crystal Quade, a Springfield Democrat.
The extended Medicaid coverage would be funded through the American Rescue Plan Act, which allocates money for states to do so. Thus far, 26 states and Washington, D.C. have extended their postpartum coverage to a year post-pregnancy.
In Missouri, mental health conditions are a main contributor for pregnancy-related deaths, according to a state report released earlier this year. A state dashboard tracking those deaths from 2017 to 2019 found that they disproportionately impacted Black Missourians, and that almost 63% of those deaths occurred between 43 and 365 days postpartum.
One Democrat, meanwhile, wants to revisit Missouri’s abortion ban and clarify that ectopic pregnancies qualify as medical emergencies, and are thus legal circumstances for abortion. Senate Bill 62, filed by Sen. Greg Razer of Kansas City, would also tweak the law to make clear that use of birth control would not qualify as a form of abortion.
“I oppose Missouri’s total ban on abortion, but I hope those who support it can at least see the need to protect women’s health in these specific situations,” Razer said in a statement announcing the legislation.
Advocates and opponents to the state’s ban have expressed concern about the law’s current vague language surrounding ectopic pregnancies and medical emergencies, which could bar health care providers and attorneys from acting in quickly-developing urgent medical situations. A bill proposed last year that would have criminalized aborting potentially fatal ectopic pregnancies was widely criticized and later amended to remove that language.
Lawmakers will also look for ways to improve the affordability and accessibility of child care in Missouri, as parents in the state and throughout the country struggle with an industry that is often out of their price range and short-staffed.
On the campaign trail this fall, child care emerged as a priority that lawmakers on both sides of the aisle frequently heard about from constituents — a key issue that prevents many families with young children from being able to balance caring for young children while regularly working. While the General Assembly could seek specific legislative solutions, it appears more likely that the path forward will be through the state budget, with options including tax credits, grants or other programs to invest in child care.
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“We’ve really seen over the last two years, post-COVID, lots of conversation from the business community as well,” Quade said. “It’s been a really big economic development problem for our state as well. We’ve had lots of conversations with folks on the other side, as well as the governor’s office.”
She said it was her understanding that Gov. Mike Parson was preparing “a whole child care package” as part of his priorities for the legislative session. Parson will formally unveil his priorities as part of his annual State of the State speech in January. Quade has also filed her own bill, which would allow Springfield and Greene County to create a sales tax funding early childhood education programs.
Kids Win Missouri, an advocacy group that focuses on children’s issues, is also developing an “investment blueprint” for the session, detailing how money should be allocated. But Robyn Schelp, Kids Win Missouri’s policy director, argued the burden does not lie with the legislature alone.
“It’s not just something that our government needs to step in and take care of,” Schelp said. “This is a statewide issue, it’s a community issue. Businesses are going to have to step up.”
The group will be advocating for another increase in reimbursement for child care facilities, as well as additional subsidies; Schelp said the reimbursement system also needed to be tweaked to allow more stability. Currently, child care facilities receive money back based on children’s attendance at their services; Kids Win Missouri wants it to be based on enrollment instead.
Last session, several lawmakers made initial steps during the budget process to direct money toward child care. Rep. Betsy Fogle, a Springfield Democrat, added an amendment on the House floor that directed $20 million in federal dollars toward child care for essential workers and employees of small businesses. The legislature also authorized a 5% rate increase in reimbursement for child care providers and funneled around $9 million to First Steps, the state’s early intervention program for infants and toddlers.
Galen Bacharier covers Missouri politics & government for the News-Leader. Contact him at, (573) 219-7440 or on Twitter @galenbacharier.


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