October 4, 2022

JEFFERSON CITY — Republican infighting in the Missouri Senate may have doomed the passage of a wide-ranging package of changes in state health care policy this year.

With the clock ticking on the Legislature’s annual session, Sen. Bill Eigel, R-Weldon Spring, led efforts among a splinter faction of conservative Republicans to help derail the legislation, which once included the extension of health care benefits for new moms, as well as a needle exchange program.

With a 6 pm Friday deadline looming and other business pressing on the Senate, the measure was put on hold Wednesday amid a filibuster by Eigel. It could return for further debate, but time is running short.

The sponsor of the legislation, Sen. Holly Rehder, R-Sikeston, called Eigel and his hard-line faction of him “disgruntled.”

“These guys can’t deal with the fact that I don’t let them push me around,” he said in a Facebook post during the filibuster. She later relented and removed the bill from consideration in order to allow other Senate business to continue.

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The measure designed to address the state’s troubling maternal mortality rate had been part of a larger package of health related laws sought by a bipartisan coalition of lawmakers and groups. But opposition from conservative Republicans forced supporters to remove the provision from the legislation in order to save other pieces of the package.

“With the pushback on that, we had to remove it,” Rehder said.

The idea had received bipartisan support, as well as backing from groups on both sides of the abortion spectrum.

Rehder said removing the postpartum language was a trade-off to save her long-running effort to decriminalize needle exchange programs, which are aimed at allowing drug users to get new syringes so they don’t spread bloodborne diseases like HIV.

Rehder has filed a version of the needle exchange bill since 2016, when she was a member of the House.

The final version of the bill also includes plans to create a prison nursery program, allowing mothers to stay with their newborns while they are incarcerated.

As part of the horse-trading, lawmakers also removed a provision that would decriminalize fentanyl testing strips, which can detect the presence of the deadly drug if it is mixed with other drugs.

“That one has some pushback,” Rehder said.

But, Render’s preemptive maneuvering wasn’t enough for members of the Senate’s conservative caucus, who were targeted in March by Rehder and other senators for obstructing proceedings earlier in the session.

Missouri’s maternal mortality rate is particularly dire for women on Medicaid.

According to the Missouri Department of Health and Senior Services, women receiving the limited, 60 day postpartum coverage are four times more likely to die within a year of pregnancy compared to those covered by private health insurance.

In a report, DHSS said the pregnancy-related mortality rate was 33 deaths per 100,000 live births in 2018, up from 26 in 2017 and that 82% of those deaths were determined to be preventable.

The legislation is Senate Bill 690.

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