The Missouri General Assembly ended the 2026 legislative session after making a number of changes to healthcare in Missouri. Key changes included “Food is Medicine” coverage under state insurance, requiring health insurance coverage of a year’s supply of oral contraceptives and allowing ambulance districts to consolidate without a public vote. 

Although lawmakers passed about a dozen bills related to healthcare, it will be up to Gov. Mike Kehoe to decide what becomes state law by mid-July.

Kehoe will also be faced with a budget for the Department of Social Services, which oversees programs like Medicaid and SNAP, as the agency prepares to put changes in place from the Trump administration’s sweeping One Big Beautiful Bill Act. 

Here are some of the key pieces of health legislation passed by the Missouri General Assembly in 2026. 

Missouri healthcare package includes 340B reform, access to oral contraceptives, doula coverage

A large healthcare omnibus bill carried by Rep. Tara Peters, a Rolla Republican, passed the General Assembly this year, which includes changes to how Missouri patients can receive healthcare. 

HB 2372 makes a number of changes to pharmacies and prescriptions. 

Notably, the bill requires insurers and pharmacy benefit managers to reimburse providers of 340B drugs, a class of federally discounted drugs for safety-net providers, at the same rate as other non-safety-net providers. 

It would also require health insurance plans in Missouri to cover alternatives to opioid drugs, and would bar tactics that may encourage providers to prescribe opioids over nonopioid alternatives, like lower reimbursement rates. The bill would also allow some patients to access investigational drug trials and treatments that haven’t received full federal approval. 

The legislation also makes changes to maternal health and birth control access by requiring health insurance plans in Missouri to allow patients to get a full year’s supply of oral contraceptives at once, instead of refilling a prescription every few months. 

It would create coverage for doula services under Missouri’s Medicaid program, MO HealthNet, and allow physicians working with Medicaid patients to recommend doula services to their patients. 

Similarly, it would also allow Missouri’s Medicaid patients to have access to “Food is Medicine” programs by covering certain diets and nutrition counseling prescribed by a professional. 

And as more emergency response departments across Missouri consider regionalizing their services, the omnibus legislation would allow the boards of directors of ambulance districts to consolidate their ambulance district with a nearby provider, instead of requiring voter approval before a consolidation can occur. 

The bill would allow for a public vote to stop a consolidation of ambulance districts, but would otherwise create provisions to speed up consolidation. 

The omnibus legislation also updates the definition for epinephrine devices to include new technologies, and would add alpha-gal syndrome to the list of illnesses that must be reported to the Department of Health and Senior Services. 

It would require childcare providers to adopt an allergy prevention plan, and would modify hospital investment plans by allowing some hospitals to invest up to 50% of their nonoperating funds. 

Drugs and pharmacies 

A bill regulating medical drugs and pharmacies also passed the General Assembly and includes some similar provisions to the large healthcare bill package. 

SB 878, sponsored by Sen. Travis Fitzwater, a Holts Summit Republican, mirrors language related to 340B drugs passed in HB 2372. It also has language included in the healthcare package that allows for ivermectin and hydroxychloroquine to be sold over the counter in Missouri. 

The legislation would also allow pharmacists to prescribe some medical devices and would allow them to administer updated versions of vaccines. 

Lyme disease in Missouri 

A bill sponsored by Sen. Sandy Crawford, a Republican representing parts of central and southwest Missouri, will require the Department of Health and Senior Services to track Lyme disease cases and publish annual reports on its prevalence in Missouri. 

The legislation also includes the same changes to hospital investments as HB 2372, the large healthcare package. 

Divorcing while pregnant 

After years of debate on the topic, lawmakers clarified language that allows a pregnant woman to get a divorce or legal separation ruling in HB 1908, sponsored by Rep. Cecelie Williams, a Republican representing Jefferson County. 

Kehoe signed this legislation into law in April. 

Before the changes, judges often did not finalize divorce proceedings because courts would wait to resolve custody and child support issues after birth. This legislation prevents divorce proceedings from being put on hold due to a pregnancy. 

Maternal health and abortion protection 

Lawmakers passed a comprehensive bill outlining new guidelines for women’s health, sponsored by Republican Sen. Brad Hudson, who represents a district in south central Missouri. SB 999 includes the Born Alive Abortion Survivors Protection Act, which requires medical providers to use the same degree of medical care for an infant born alive during or after an abortion as any other newborn patient in Missouri. 

The legislation also creates civil liability for providers and clarifies that Missouri’s current homicide laws apply if a born-alive infant is intentionally killed. 

The legislation would also make changes to Missouri’s Pregnancy Associated Mortality Review Board by adding a member to the board from each of Missouri’s congressional districts. It would require the board to examine new factors for pregnancy-related deaths, like the timing of prenatal and postnatal care and whether deaths happened in maternity care deserts. 

The bill also changes provisions for stalking and harassment by adding offenses related to cyber harassment, cyberstalking and nonconsensual distribution of intimate images, known as revenge porn. 

Alert system for missing people with developmental disabilities 

Rep. Sherri Gallick, a Republican from Belton, sponsored HB 1840, which would create a statewide alert system and course of action for when people with developmental disabilities go missing in the state of Missouri. 

Licensure reciprocity for dietitians, trainers and physician assistants 

HB 2974, sponsored by Rep. Melanie Stinnett, a Republican from Springfield, would allow physicians who practice in Missouri through an interstate reciprocity agreement to provide telehealth services to their patients in Missouri. 

It would also create license reciprocity compacts for dietitians, physician assistants and athletic trainers and put in place oversight procedures for states that participate in the compact.