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Abortion bill could cost Missouri $7B in Medicaid funding

February 14, 2019 GMT

JEFFERSON CITY, Mo. (AP) — Republican House Speaker Elijah Haahr on Thursday called a bill to ban most abortions after a fetal heartbeat is detected a priority, but a Democratic leader cautioned that enacting it could blow a massive hole in Missouri’s budget.

An estimate by legislative researchers puts the bill’s price tag at anywhere between nothing and the state’s yearly share of federal Medicaid funding, which amounts to more than $7 billion.


“The fiscal note is essentially saying that we are very likely to lose our Medicaid reimbursement rates if that bill goes through,” Democratic House Minority Leader Crystal Quade said Thursday.

Republican Rep. Nick Schroer’s bill includes an exception for medical emergencies, but not for cases of rape or incest. Department of Social Services officials told legislative researchers that not including those exceptions could conflict with federal law and “result in the loss of all federal Medicaid funds,” according to the fiscal note.

States are banned from using federal funding to pay for abortions except in cases of rape, incest or to save the life of the mother.

Schroer said he needs to do more research on whether his bill would put Missouri out of compliance with federal Medicaid rules and said he’s open to talking about adding exemptions to the list.

“If anybody has any way of addressing these concerns to make sure that we aren’t stripped of federal funds, I’m willing to discuss it,” said Schroer, of O’Fallon.

But he also said he’s open to forgoing federal money if it means “saving lives.”

“What value do you put on life?” Schroer said. “I’m willing to walk away from what I would call blood money that if you get rid of abortion or if you limit abortions, the federal funds aren’t going to be there for whatever purpose.”

Schroer’s bill would also require providers to check for a fetal heartbeat before performing abortions or pay a $1,000 fine. Failure to do so could result in loss or revocation of physicians’ medical licenses. The bill is scheduled for a House committee vote Tuesday.

A similar measure by Republican Sen. Andrew Koenig has not yet received a hearing.


Iowa Judge Michael Huppert last month struck down that state’s abortion law on fetal heartbeats as unconstitutional. He cited several cases in federal court, including decisions in 2015 and 2016 in the 8th U.S. Circuit Court of Appeals that indicated such abortion laws were unconstitutional.