Missouri lawmakers are back in Jefferson City, and health care is a hot topic on both sides of the aisle. 

Lawmakers have introduced hundreds of bills aiming to reshape health care across various industries, like tightening the rules in the 340B drug pricing program or allowing private insurance coverage of oral contraception for up to a year. Lawmakers are also looking to curb how artificial intelligence can speak with users about mental health or be used in health care marketing. 

But as they consider these reforms, lawmakers will have other major health care changes looming over the legislative session. As part of the Trump administration’s budget bill, H.R. 1, as many as 170,000 Missourians across the state could lose access to Medicaid, known as MO HealthNet. 

And as Missourians lose health coverage, costs could go up for the state. As part of the Trump administration’s budget bill, states will be on the hook for picking up more of the cost of providing health care. 

All the while, Missouri will begin laying the groundwork for its Rural Health Transformation project, which will draw more than $215 million into the state in its first year to help create community health care hubs, shore up health care recruitment and retention and improve data-sharing capabilities of providers. 

Large health care package returns 

One of lawmakers’ top priorities is passing an omnibus health care package that was stitched together during the 2025 legislative session. 

For uncontroversial bills and simple reforms, it can be easier for lawmakers to concentrate them into one piece of legislation rather than debating all of the bills individually, said Rep. Melanie Stinnett, a Springfield Republican who chairs the House Health and Mental Health Committee. 

The legislation has similar versions in the House, HB 2372, sponsored by Rep. Tara Peters, a Rolla Republican, and in the Senate, SB 841, sponsored by Sen. Mike Bernskoetter, a Jefferson City Republican. 

The omnibus legislation creates a number of health-related awareness days. It also allows hospitals to invest more money into mutual funds and certain bonds. 

The bill would create more collaboration between community ambulance providers and community paramedics depending on their respective coverage areas. 

It would also make some changes to maternal care and how doulas work with the state. The legislation would allow for the Department of Social Services to make general recommendations about using a doula throughout one’s pregnancy, and would also allow the department’s officials to create new medical recommendations for prenatal vitamins.

The legislation would create reimbursement pathways for doula services under MO HealthNet and allow doulas to enroll as providers with certain managed-care payers affiliated with Medicaid in Missouri. 

“We’ve made some progress, and I’m grateful for the things we’ve been able to accomplish,” Stinnett said about maternal health. “We’ve got some bills regarding maternity and maternal health services. I’m anxious to get to those conversations, because I think when we support mothers, when we support babies and families, obviously we see a healthier community overall.” 

The bill also prevents health care providers or pharmacy benefit managers from discriminating in any way against drugs that are part of the 340B program, an effort that has been underway for several years in the General Assembly. 

Prior authorization 

A priority in both the House and the Senate is to reform Missouri’s guidelines around prior authorization from insurance companies for medical services. 

Senate Majority Caucus Chair Ben Brown, a Washington Republican, is carrying the bill in the Senate.

The legislation would not require providers to get prior authorization for a service if more than 90% of the prior authorizations given to that provider were approved over a certain time frame. 

“If that is the case, they don’t have to submit prior (authorization) for the next time frame,” Stinnett said “That really just allows them to see patients, make sure patients are getting quicker access to care, and don’t have that red tape and barrier to service for the patients.” 

Insurance coverage 

Insurance coverage of certain drugs or medical devices is also a topic of interest for both Republicans and Democrats. 

Rep. Carolyn Caton, a Blue Springs Republican, is sponsoring a bill to require MO HealthNet and other insurers to cover prosthetic, orthotic or assistive devices for daily life and for physical activities or things like showering or bathing. 

Caton took up the legislation after hearing from an advocacy group about the difficulties of getting assistive devices for physical activity or sports covered by insurance companies. 

“I didn’t go there with the idea of being a champion,” Caton said. “But I was so absolutely moved and somewhat heartbroken by some of the stories that I have heard … that I walked out of there going ‘I’m going to do whatever I can to make sure that these activities, prosthetics and wheelchairs are going to be covered by insurance.’” 

Her legislation is similar to HB 1658, filed by Sugar Creek Republican Rep. Mike Steinmeyer, which would require insurance coverage of orthotic devices throughout the state. 

Many lawmakers also filed legislation to require insurance coverage for drugs that are an alternative for opioids. The legislation would make it unlawful for a health insurance plan to deny coverage of a nonopioid prescription in favor of an opioid prescription, or require a higher level of cost-sharing for a nonopioid prescription. 

Prescriptive authority and scope of practice 

Both Republicans and Democrats filed various bills related to the scope of practice for advanced practice nurses and their purview. 

Rep. Bennie Cook, a Republican from Houston, filed legislation to allow registered nurse anesthetists to administer certain controlled substances while caring for a patient. 

Sen. Patty Lewis, a Kansas City Democrat, filed legislation to remove the collaborative practice agreement for all advanced practice registered nurses, aside from nurse anesthetists, who have been collaborating with a physician for over 2,000 hours. 

“We need to focus on removing unnecessary boundaries,” Lewis said. “All of the surrounding states have some sort of less restrictive laws when it comes to (advanced practice registered nurses).” 

Women’s health care and birth control  

Maternal health has been an area of focus in the General Assembly for several years. While the large omnibus bill would create more access to doulas across the state, lawmakers have their eyes on more improvements. 

HB 1950, sponsored by St. Louis Democrat LaKeySha Bosley, would require the Department of Health and Senior Services to establish a fetal infant mortality review process where all public health agencies across the state may voluntarily participate. The board would be tasked with reviewing at least 20% of the cases of infants who died and would put in place more monitoring metrics for the state board that reviews pregnancy-associated mortality. 

Another bill, sponsored by Rep. Jo Doll, a St. Louis County Democrat, would require providers to screen pregnant women for mental illnesses as early as possible in their pregnancy. 

Another bill introduced by Lewis would allow private insurers to prescribe oral contraceptives for up to one year.