Melanie Stinnett – Missouri House of Representatives Newsroom

VIDEO: House Endorses Bill to Speed Up Health Care, Limit ‘Prior Authorization’

The House has voted for the second straight year to decrease wait times for Missourians seeking medical care, while increasing the quality of and access to that care and lowering costs.

*Representative Melanie Stinnett (Photo: Tim Bommel, Missouri House Communications)*

Representatives voted overwhelmingly last week to send to the Senate House Bill 618, dealing with prior authorization.

“‘Prior authorization’ is a term used to describe the process for requiring healthcare providers to request approval before providing a healthcare service,” explained bill sponsor Melanie Stinnett (R-Springfield).

She said it is a practice that is, “Getting in the way of health care for every day Missourians.”

“I could go through all the components of prior authorization and all the pieces that are required but ultimately the process requires time, and it includes delays for patients. We have data from different sources that says that healthcare providers, that physicians are spending sometimes 14 hours of their week doing prior authorization tasks, and that’s time that they could be spending with patients, that’s time that they could be providing care to Missourians.”

Stinnett’s bill would free healthcare providers from having to seek prior authorization from insurance providers for a given procedure for six months, if at least 90 percent of its previous requests for authorization have been approved. The bill also lays out how a provider could maintain that exemption status through ongoing evaluations.

Stinnett, who is a speech-language pathologist, said the current process is giving power and authority to insurance companies. She recalled one case in which an insurer was denying care for one of her patients, based on the finding that the patient’s hearing loss was not congenital.

“Funny thing is, there’s not a diagnosis code for congenital hearing loss, and so there was no way for me to indicate that readily, and then going through the appeals trying to provide letters from the neonatologist and get that from the hospital and get that information from the ENT, and it was just a fight all along the way. I, as the provider, chose to go ahead and provide care uncompensated until I won that battle but it was months of a battle.”

Other legislators who work in medical fields joined Stinnett in expressing why her legislation is needed.

Springfield Democrat Jeremy Dean worked in several healthcare clinics in his district. He said legislators hear often that Missourians want more time from their physicians.

*Representative Jeremy Dean (Photo: Tim Bommel, Missouri House Communications)*

“We go and see our doctor hopefully one time a year if we’re healthy and it seems like we’re in and out, the doctor doesn’t have time to talk to us, and I think that this is one of the prime reasons that has caused doctors to feel like they are so stretched thin for time, is because they’re doing so many other things to please our insurance companies,” Dean told Stinnett during debate in the House.

“Thank you so much for bringing this bill forward. It’s absolutely going to help our constituents and the people of Missouri.”

Representative Gregg Bush (D-Columbia) is a registered nurse. He said there is a “crisis” in Missouri and the rest of the U.S., of individuals seeking care from medical professionals being impeded by insurance companies.

“Right now in each one of our districts there is somebody who is sick and injured who’s going into a hospital, who’s going into a clinic, and instead of the clinician or a healthcare provider being able to treat our citizens who are sick and injured, [that provider is] on the phone with someone far away who’s never even laid eyes on the patient, who’s never even been around the person who is sick and injured, and is telling our health care providers what they can and can’t do. Mr. Speaker I trust our education, being able to treat the patient in front of us, and that’s why I’m urging the whole body to vote ‘yes’ on this bill.”

VIDEO: An exchange between Representatives Gregg Bush (D-Columbia) and Melanie Stinnett (R-Springfield) illustrates why they believe her House Bill 618 should pass:

“Prior authorization is literally red tape in healthcare,” said Rolla Republican Tara Peters. “When we’re sick and when we are trying to find out what’s wrong with us to try to get treatment we should not be waiting on insurance companies to make those decisions for us.”

“We recently heard a story about a person under anesthesia that the insurance company would only pay so much, and they were actually under the anesthesia and had to get authorization to get more. I mean, what kind of absurdity is that?” Peters asked. “Let’s do away with barriers that are hindering our healthy outcomes for our Missourians and let’s pass House Bill 618.”

Ozark Republican Jamie Gragg talked about his own experience as a patient with breathing issues related to allergies which used to result in him frequently being hospitalized for days at a time.

Once he was diagnosed, doctors were able to put him on medication that kept him out of the hospital “however, every year I have to go through a preauthorization, and there are times where I am off the medication for a couple of months because the preauthorization is such a headache. It’s a pain, because there are times when I’m off the medication for a couple of months that I have issues with breathing again.”

“I’m not unique,” Gragg told his colleagues. “This is what people go through, and it’s even more detrimental with some other medications they have to wait for, so this is a very much needed bill.”

Though much of the sentiment expressed during debate suggested that this legislation would benefit patients over insurers, Stinnett said she believes both sides will win if it becomes law.

*Representative Gregg Bush (Photo: Tim Bommel, Missouri House Communications)*

“When providers know that their prior auth status is based on a 90 percent approval rating, they’ll be less likely to test the waters and see what they can get approved. There’ll be streamlining of what services are provided, and the motivating factors mentioned previously will be neutralized.”

“Ultimately,” Stinnett continued, “what will win out is the best interest of patients, and every Missourian will be positively impacted.”

The House voted 148-4 to send that proposal to the Senate. Similar legislation last year was voted out of the House 146-6, but it did not receive a committee hearing in that chamber.

Restoration of Voting Rights to those on Probation and Parole is Proposed

An effort to allow people on probation and parole to vote has been renewed for a third legislative session.

Springfield Republican Melanie Stinnett has filed the language of House Bill 617 since she was first elected. It would lift the prohibition on voting rights for those on probation and parole for a felony conviction, unless their conviction was for a crime related to voting or elections.

“It is, in my opinion, a small bite that makes a big difference,” Stinnett said. “It’s really my belief that we should be hoping that these individuals can reenter our communities and be successful members of our communities, and one piece of that is civic engagement.”

Stinnett’s bill has received broad support in the past two years, despite falling short of becoming law. She agreed to carry it largely because of an encounter she had while knocking doors during her first run for the House.

“I actually knocked on a door of a gentleman who was really upset that I was there knocking on his door and slammed the door in my face, wasn’t very happy with me, which is pretty uncommon when you’re door knocking, actually. People are generally pretty kind.”

A short time later, the man caught up with her.

“He was kind of teary eyed and he apologized and said, ‘I’m really sorry for how I responded but I can’t vote and it really just bothered me,’ and we had a great talk but he was in one of these situations where he had been previously incarcerated, was on probation and parole, and was unable to vote, but he is a member of our community and he is working and living in our community and it really bothered him that he didn’t have the ability to vote.”

After meeting several more voters who were in a similar situation, and some thought and reflection, Stinnett said she was quick to agree to carry the proposal.

“I said you don’t even have to sell me on it. I saw the impact in my community and I think it’s a worthwhile bill to carry and look into, and so we’ve really pushed it pretty significantly over the past two years,” Stinnett said. “We’re not just talking about voting for president, right? We’re talking about voting for school board, we’re voting for local taxes, we’re voting for city council, and these things that we talk about are impacting our everyday lives. These individuals who have done their time, been incarcerated, and been released don’t have the ability to contribute to their community in that way.”

To exempt those guilty of violating election law makes sense for obvious reasons, Stinnett said, but she has seen no reason to have additional exclusions.

“To draw a line somewhere I think for me is a challenge, because I want everyone to have the opportunity to be reinvested in their community and I don’t want to be the one kind of deciding exactly where that line is drawn.”

House Bill 617 has not been assigned to a committee. Stinnett is hopeful it will soon begin moving through the legislative process.

House Approves Plan to Reduce Wait Times, Costs for Healthcare

House lawmakers have voted to decrease the time Missourians must wait for some medical procedures, increase quality of and access to healthcare, and decrease costs.

Insurance entities require health care providers to seek prior authorization before performing some procedures before they will agree to cover those procedures. If House Bill 1976 becomes law, health care providers who reach a 90 percent approval rate for a given procedure over a six month period will then not have to seek prior authorization for the following six months.

“Insurance companies and their prior authorization standards are getting in the way of health care for everyday Missourians,” said bill sponsor Melanie Stinnett (R-Springfield).

She said the passage of HB 1976 would mean “better access to care for patients and, potentially, decreased cost for patients, because the prior authorization process, itself, increases costs within the healthcare system.”

Stinnett said without knowing it, many patients have likely had a negative experience that involved prior authorization.

“Often, [patients] feel like it is something that the doctor hasn’t done or needs to do, but in reality it’s something that the health insurers lay over on top of what the health care provider has to do,” said Stinnett. “It’s a challenge that the health care provider has to deal with, but often the patient doesn’t realize who’s imposing it or where that’s coming from.”

“As someone who has spent hours and hours and hours trying to get preauthorization for patients that need physical therapy, I cannot support this enough,” St. Louis Representative Jo Doll (D), who has worked as a physical therapist, told her colleagues. “The process is burdensome, it takes hours and hours of – people that are there to provide patient care – takes them away from patients and makes them calling, writing, submitting countless forms to get visits approved.”

*Representative Jo Doll (Photo: Tim Bommel, Missouri House Communications)*

Health care industry workers and those patients who know of the prior authorization process view it as little more than “red tape” that drives up costs and slows care, and Representative Patty Lewis (D-Kansas City) agrees, and said some doctors report that the delays it causes lead to worse outcomes and even deaths.

“Some of the witnesses who came through committee talked about the additional [workers that must be hired to do prior authorization paperwork]. We know we have a workforce shortage in the State of Missouri, so putting additional workforce just to go through red tape when they end up providing the care that’s needed … this is the right thing to do to increases access to care,” Lewis said.

The legislation made its way to the House after being approved by the Committee on Healthcare Reform. Chairman Kent Haden (R-Mexico) noted that panel gave it a bipartisan, unanimous vote.

“The only people that testified against it were the insurance people and [pharmacy benefit managers],” Haden said. “It is really good for all of our clients, all of our constituents. Not many bills we see effect everybody in the House and all their constituents. This bill will effect virtually everyone and their constituents immediately. It’s a great bill.”

Stinnett told her fellows the prior authorization process gives power to insurance companies and leaves providers fighting to get the best care and outcomes for their patients. Her legislation aims to change that, and to allow providers to focus more on patients’ needs rather than what insurers will allow.

“I think that this bill really puts a highlight on prioritizing the physician and patient relationship, and allowing the physician or the other health care provider and that patient to make their health care decisions.”

The House voted 146-6 to send that legislation to the Senate.

Guidance on non-opioid pain management options would be offered under House proposal

Many Missourians want to avoid opioids when given an option for dealing with pain, and one state representative wants to make sure they know what their choices are.

House Bill 2182 would require the Department of Health and Senior Services to create an educational pamphlet on the use of non-opioid options for pain management. It would cover pharmacological and non-pharmacological treatments and related advantages and disadvantages.

It’s sponsored by Springfield Republican Melanie Stinnett.

“Some people know that if they are presented with or given an opioid within their care, that they are at a higher likelihood of becoming addicted to that, and we want to give people as many choices as possible to say, ‘I want to choose something else,’ and so if they don’t know that there are other options, then they don’t know that they can provide that other option when they’re talking with their physician,” Stinnett said.

“I think many of us are familiar with opioids and what opioids are and what they do, and maybe there are people who would say, ‘Well if an opioid’s my option, I want pain management when I go to the doctor for a certain procedure,’ but if they know there are other, non-opioid options that could present the same pain relief for them, then maybe they would make that choice instead.”

To Stinnett, this would be a continuation of the legislative efforts that have surrounded opioid abuse for many years.

“I think every step that we can take, when we’re talking about decreasing opioid use, is an important step toward making sure that our communities are safe and the people within our communities have options to choose for themselves, so they can maintain their safety.”

The proposal has not been referred to a committee. With the session entering early March, Stinnett knows that isn’t encouraging, but she’s hopeful the one-page provision can be added to some other legislation. Even if it does not gain traction this year, she said the Department has been receptive and could create a pamphlet anyway.

In any case, she wants to see her idea become law to make sure such pamphlets are created, maintained, and updated as an ongoing educational tool.

Even in the absence of a pamphlet, Stinnett encourages Missourians to talk to their doctors and ask about their options.

“If a physician, or another provider, or maybe you talked with somebody who had a similar procedure and they said, ‘Oh, these are the pain medications that I took,’ ask about your options. It’s important that we’re always inquisitive about what’s available or us in our healthcare so that we can make choices.”

“I think it makes sense for us to be prepared consumers of health, so before you go into a doctor’s office before you go in for any kind of healthcare, you need to be prepared with any kind of questions or thoughts that you might have,” Stinnett said.

HB 2182 has been referred to the House Committee on Healthcare Reform.

Bills could help Missourians with disabilities advance their careers, get married

Missourians living with disabilities could no longer have to reject raises and promotions, or even choose not to get married, in order to keep receiving needed state assistance, under legislation now awaiting the governor’s action.

Among legislation that was approved by the House and Senate last month was a provision to change the state’s Ticket to Work health insurance program within MO HealthNet. It would increase the limit on how much a person can earn before they lose benefits under that program. It would also not count up to $50,000 of a spouse’s income toward that limit.

Such state benefits provide to some Missourians with disabilities things like personal care attendants, medication, services, and equipment that allow them to have a job in the first place. Those Missourians must sometimes reject raises or promotions because the changes in income would not offset the benefits they would lose.

Another provision would require state agencies to use an “employment first” policy, directing them to recruit and keep employees with disabilities and create competitive ways to integrate them into workforces.

This legislation received broad, bipartisan support in both chambers. In the House they were carried by Springfield Republican Melanie Stinnett. She said legislators have been growing more aware of how state assistance programs designed to help Missourians are sometimes holding them back.

“When we look at how this language in the current statute was impacting their ability to continue taking those raises or getting a new job in a new area, or in our communities we hear issues with workforce all the time and we’re wanting to do upskill training and we’re wanting to do all of these things to help people improve their skills and improve their earning potential but for individuals with disabilities we put a cap on that, and that is not what we want to be doing. We want to allow individuals in our communities to work to their highest capacity and help them to thrive within their community.”

“It’s something that’s been worked on for nearly 20 years and there are a lot of people that have worked on it year over year over year, and I’m really happy to be a part of the team to bring it across the finish line,” said Stinnett.

Representative Bridget Walsh Moore (D-St. Louis) lives and works with a disability, and has long advocated for these changes. She said these will yield, “immediate, tangible results that are going to benefit so many people.”

*Representative Bridget Walsh Moore (Photo: Tim Bommel, Missouri House Communications)*

“We will have a different workforce by the end of this year. This goes into effect in August. By the end of the year … our workforce will look entirely different because these people can go after that promotion, apply for that new job, they can move up the ladder, now it’s worth it to go back to school and get that degree or my master’s because I’ll actually be able to get the job I want,” said Walsh Moore.

“This will have immediate results on the economy, immediate impact. When you go from making 40-grand to 80 overnight you’re going to spend that money. You’re either going to pay off debt, you’re going to get a better place to live, you’re going to go out to eat more, you’re going to buy new clothes, whatever. You’re going to spend that money. When you’ve been told that you have to penny pinch for so long, that money’s going to end up immediately back in the economy, so it’s a double benefit to the state. The state is only winning in this situation.”

Stinnett is particularly excited about the provision to ease the limit on a spouse’s income, “So we’re not disincentivizing marriage for individuals with disabilities, which I think is really important.”

About that provision Walsh Moore mentioned a childhood friend of hers who developed lupus.

“She is still living with her long-time boyfriend. She couldn’t get married because she would lose her benefits because her boyfriend makes too much money but he can’t solely support her. She could get married later this year. That’s huge,” said Walsh Moore. “You hear all the time of people divorcing so they can deal with medical issues – just divorcing on paper so that they can handle whatever disease has come into their life. It’s awful.”

Supporters of the employment first language said it was long overdue and would allow Missourians with disabilities to work to their fullest extent, which benefits the whole state.

Stinnett said it is, “showing that Missouri really values individuals with disabilities in our workforce and wants them to have options for competitive, integrated employment within their communities.”

Walsh Moore, who had advocated for this legislation since being elected in 2020 and said it has been proposed long before that, said, “It’s very exciting to finally see it done … it didn’t get a hearing every year but every year it did, no one has ever testified against it and no one has ever voted against it.”

Governor Mike Parson (R) has until July 14 to act on Senate Bill 106 and Senate Bill 45, both of which contain these provisions. He could sign them into law or veto them, or let them become law without his action. If they become law, the provisions would become effective on August 28.

Extension of postpartum coverage for low-income mothers expected to save lives, awaits governor’s action

One of the measures the Missouri legislature approved before its session ended last week could save and improve the lives of mothers and their infants, and get the state out of the basement in state rankings for infant and maternal mortality.

Amendments added to two bills, Senate Bill 106 and Senate Bill 45, would extend MO HealthNet or Show-Me Healthy Babies coverage for low-income pregnant women to a full year after the end of their pregnancy. Currently that coverage stops after 60 days.

At the beginning of the legislative session a bipartisan group of six House members had filed that proposal, with several more having co-sponsored it.

“It takes a team of people that really care about legislation to move it and I’m just proud to be a part of that team,” said Representative Melanie Stinnett (R-Springfield), one of those sponsors.

“I think it makes a big difference for women who are looking at what life looks like after birth and how they can take care of themselves well and make sure that their family is healthy also. It really is going to impact children, also. I spoke when I testified in the House hearing about how important that first year of life is for a child, and if that mom’s getting healthcare she can ask those important questions about those things that are impacting her child, as well, so I think there are a wide variety of impacts that we’re going to see for families.”

It was the fourth time Representative LaKeySha Bosley (D-St. Louis) had brought the idea forward, and she said she was ecstatic to see one of “her babies” reach the governor’s desk, and for it to have been part of a truly bipartisan effort.

*Representative LaKeySha Bosley (Photo: Tim Bommel, Missouri House Communications)*

“Everybody was just excited about actually doing something around postpartum that could really make a difference,” said Bosley.

Legislators heard time and time again that a reason to pass this legislation is that Missouri is one of the lowest ranked states in terms of maternal and infant mortality. Representative Patty Lewis’ (D-Kansas City) background includes more than 20 years in nursing. She said this extension will make a huge difference for low-income Missouri mothers, and thereby help Missouri improve that ranking.

“Currently an average of 60 Missouri women die within one year of being pregnant … seventy-five percent of these deaths are preventable, so extending the coverage from 60 days to one year will absolutely address our maternal mortality rate in this state.”

Many Republicans point out that the measure is also fiscally conservative. By improving outcomes for mothers, and thereby for their infants, many of them will require less state assistance and will make fewer emergency room visits.

Sedalia Republican Brad Pollitt said, “I didn’t vote for expanded Medicaid but this isn’t an expansion, this is just an extension for a select few who kind of fall through the cracks. I was glad that we were able to give them the opportunity to have this coverage to cut down on the number of deaths, not only in the mothers but also the babies.”

*Representative Patty Lewis (Photo: Tim Bommel, Missouri House Communications)*

He adds, “I’m pleased that we had a bipartisan, pro-life bill that we could come to an agreement on and pass and get it to the governor’s desk.”

Democrats say the bill was especially important in the wake of last year’s U.S. Supreme Court decision that triggered a law banning most abortions in Missouri.

“We need to give [women] access to the services and the care that they need in order to stay healthy in order to raise those babies,” said Bosley.

She noted that some groups in Missouri are impacted more greatly by infant and maternal mortality than others.

“As an African American woman I am three times more likely to die during childbirth in the State of Missouri and throughout this country, so to be able to give women who look like me and poor women across this state an opportunity to be able to have lifesaving [healthcare], like we’re actually changing lives, that was the purpose of us being sent here.”

Bosley said this additional coverage for mothers and infants impacts an entire family. People often don’t think about what a partner goes through when a mother or infant are sick.

*Brad Pollitt*
*(Photo: Tim Bommel, Missouri House Communications)*

“From a partner’s perspective, who doesn’t know how to identify the signs of when someone is going through a postpartum, maybe postpartum depression, this also gives them the ability to learn and to advocate on behalf of their partner – behalf of the mom and baby, so not only are we saving mommy and baby’s lives, we also are saving relationships and families and building a cohort around how we can do that for mommy, baby, and papa.”

Each of these lawmakers spoke to House Communications through huge smiles as they talked about getting this legislation to the governor.

Said Lewis, “One of the main reasons I ran for office is because I believed I could save more lives on a macro level through policy, and this particular bill is something that will truly save lives.”

Pollitt added, “It’s a good thing. It’s something we should do. I think it’s a common sense approach.”

This provision would become law immediately upon SB 106 or SB 45 becoming law. Those bills are now awaiting action by Governor Mike Parson (R), who could choose to either sign them into law, allow them to become law without his action, or veto them.

Help for low-income and disabled Missourians a focus in final days of session

In the House, proposals that would help Missourians with disabilities, those with low incomes, and new mothers on state assistance, are being given every chance to become law before the end of the session next week. The chamber has voted to add those pieces of legislation to several bills that are still in play in these final days.

Among those is a transitional program meant to help people get off of state assistance gradually as their income increases. House members say the state’s assistance programs for low-income Missourians trap people in poverty because if they accept a raise that puts them above a program’s limits, they could lose more in state benefits than they gain from a raise.

The measure, sponsored by Representative Alex Riley (R-Springfield), would let people incrementally transition off of state assistance, “Trying to create this transitional system that encouraged people to work, that encouraged people to take those raises and to start to work their way up the income ladder and to hopefully, once this goes into effect, actually reduce the number of people receiving benefits in the state.”

That provision is the product of years of work by members of both parties. Lee’s Summit Democrat Keri Ingle called it a, “great bill … it’s been a bipartisan effort to essentially wean folks off of assistance, whether it’s TANF or SNAP, and make it easier for Missourians to get what they need to be successful working citizens while at the same time making sure that all of their needs are being met.”

The House has voted this week to add that language to two bills. It did the same for language sponsored by Representative Melanie Stinnett (R-Springfield) that could allow individuals with disabilities to finally be able to advance in their careers without worry of losing state assistance.

The changes to the state’s Ticket to Work health insurance program within MO HealthNet would increase the limit to how much a person can earn before they lose benefits, and would not count up to $50,000 of a spouse’s income toward that limit. It would also direct state agencies to have policies to recruit and keep employees with disabilities and create competitive ways to integrate them into workforces.

“These are people who are actually begging us to work, who want to work, who want to get promotions, who want to seek new jobs. What [this] bill does is address the fiscal cliff, making sure that you don’t have to do quite as much of a tap dance that too many people in our state are doing, where you’re allowed to make so much money but only to a certain point,” said St. Louis Democrat Bridget Walsh Moore.

Walsh Moore, who lives and works with a disability, said the benefits that individuals stand to lose often enable them to have a job in the first place. Things like, “a personal care attendant, your health insurance your additional services and equipment that you receive through the state that allow you to work. This would address and allow you to make more money, put that money back into the economy because if you make more money you’re going to spend more money.”

*Representative Alex Riley (Photo: Tim Bommel, Missouri House Communications)*

Also supported in the House this week has been a bipartisan plan to extend post-partum coverage under MO HealthNet or Show-Me Healthy Babies from 60 days to a year.

Stinnett, one of several sponsors of this proposal, said, “In 2019, 75-percent of pregnancy-related deaths in Missouri were determined to be preventable; those deaths that were attributed to things like embolism, hemorrhage, infections, concerns with cardiovascular health, chronic health conditions, and there’s one common denominator that can save these women’s lives, and that’s healthcare access.”

Several Republicans have cited this as an important pro-life provision. Representative Darin Chappell (R-Rogersville) said, “We who talk about being pro-life, I don’t know how we do that and then cut off the most vulnerable of our society after 60 days … I believe if we’re ever going to spend money [on benefits programs] it ought to be for those most vulnerable among us. Those very ones that we fought for them to be able to be born. We have to take care of them.”

Representative Tony Lovasco (R-O’Fallon) said even very conservative Republicans like himself could get behind all of these proposals, which don’t expand the state’s assistance programs.

*Representative Keri Ingle (Photo: Tim Bommel, Missouri House Communications*

“The reality is we are in a situation where we all, in all of our districts, have employers that are begging for workers. The number of unfilled positions right now is just astronomical and the idea that we as a state might incentivize people to stay home and not work and not take a promotion, not take a job opportunity because they might just make a slim little bit more money that puts them in a hole when it comes to feeding their family, well that’s just insane.”

Sponsors are hopeful at least one of the bills containing these provisions will reach the governor’s desk before the session closes at 6pm on May 12.

House votes to extend opportunities for more jobs, greater salaries to persons with disabilities

The House has voted to expand access to job opportunities and greater salaries to Missourians with disabilities by passing legislation that, backers say, will let those people simply live their lives.

House Bills 970 and 971 make changes to the state’s Ticket to Work health insurance program within MO HealthNet. The key provisions increase the limit to how much a person can earn before they would lose benefits under Ticket to Work and disregard up to $50,000 of a spouse’s income, relative to that limit. It will also direct state agencies to have policies to recruit and keep employees with disabilities and create competitive ways to integrate them into workforces.

The bills are carried by Representative Melanie Stinnett (R-Springfield), whose career in healthcare and as a speech-language pathologist has included a great deal of focus on serving the disabled community. She said she is honored to sponsor this legislation.

“It provides language that tells individuals with disabilities that we value them as important members of our community. It allows these individuals to enjoy the opportunity to enjoy competitive, integrated employment by decreasing barriers imposed by government,” said Stinnett.

She said these changes address outdated statutes that might have made sense in their time, but set limits that today are far too low.

“The restrictions we have in place limited them from being able to utilize the degrees that they had and the skills and the trades that they had in our communities in an effective way, and with today’s work force crunch, too, we certainly don’t want to be limiting our workforce,” said Stinnett.

The legislation has been offered in the House for about eight years. One person who has carried it throughout that time, Representative Sarah Unsicker (D-Shrewsbury), said individuals with disabilities have Missouri’s lowest unemployment rate, largely due to discrimination and lack of accommodation and understanding.

“Disability is a natural part of the human condition that affects everybody at some point in their lives, some sooner than others. The existence of a disability should not stop somebody from working and living to their fullest capacity,” said Unsicker. “There are people right now with master’s degrees who cannot work because of services they need just to get out of bed and survive and be physically able to meet the day even if they are mentally able to do incredible work. This will help them be taxpayers to the fullest extent of their ability. This will help people get jobs.”

Representative Bridget Walsh Moore (D-St. Louis) is a Missourian living and working with a disability and has also for several years sponsored this legislation. She said some people in the disabled community choose not to get married because if they do while the current limits are in place, they will lose their health benefits under Ticket to Work.

In her own life, said Walsh Moore, “If anything were to happen to me, my husband makes over $60,000. We would receive nothing from the state, zero support, and $60,000 for the two of us plus our child is not enough, especially with any medical needs I might have,” said Walsh Moore.

She said individuals need the benefits provided by that coverage to function daily, to hold jobs, and to live with dignity. She said she often thinks of a friend of hers who is in her 20s and has a master’s degree.

“She had to go to her job and say ‘Cap my salary at 40 grand.’ They wanted to pay her almost double that and she had to say no because even 80-thousand won’t make up enough to cover the assistance [she needs]. She is in a powered wheelchair so she has someone who helps her in morning and night, in getting in and getting out of bed and all that, and it’s not enough.”

“Missouri is losing out twice. They’re losing out on her income tax, and that’s another 40-grand that would have gone into our economy,” said Walsh Moore.

She said the provisions aimed at state agencies are intended to create a system that can be a model outside of government.

*Representative Sarah Unsicker (Photo: Tim Bommel, Missouri House Communications)*

“As the system stands, we have sheltered workshops and we have full competitive employment and no bridge in between. What this would do is basically set up the state as a model employer. Basically, we will figure out a program ourselves. All state departments will hire people with disabilities. We’ll kind of work out the kinks, figure out the program ourselves, and then we can sell it to corporate America,” Walsh Moore explained. “A lot of corporations I’ve talked to are very interested. They like the idea, they just don’t know what that looks like, and so we’re taking that burden off of them and saying we’ll do it first and we’ll figure it out.”

Stinnett, who is in her first year in the House, said this was one of the first issues she asked about taking up.

“It’s something that’s come up in my work life outside of this building and was a really important thing to me that I found disability legislation that I could get across the finish line that would make a difference for our everyday Missourians living with disabilities.”

The House voted 151-0 to send the legislation to the Senate, and has amended it to other bills.

Bipartisan set of bills would extend post-pregnancy healthcare

A bipartisan group of House lawmakers is sponsoring legislation that they hope will save the lives of women and infants in Missouri, and in doing so, move the state farther from the bottom in the nation in infant and maternal mortality.

*Majority Floor Leader Jon Patterson (R) (Photo: Tim Bommel, Missouri House Communications)*

Their proposals would extend MO HealthNet or Show-Me Healthy Babies coverage for low-income pregnant women to a full year after the end of their pregnancy. Currently that coverage stops after 60 days.

Six representatives have filed that proposal, including Majority Floor Leader Jonathan Patterson (R-Lees Summit).

“The wellbeing of the child is based upon the wellbeing of the mother, so that’s why we’re really worried about, and we really want to focus on, healthcare for the mother, because it affects the child,” said Patterson.

He says there are about 5,000 women in Missouri who don’t have insurance coverage either through the state, personal coverage, or an employer.

“The data are very clear that it’s critically important. You’re talking about the physical development of the child, development of the brain, that they have support, and one of those things is having a mother that can be there. For example if your mother is in the hospital for a mental crisis or high blood pressure they can’t be there for the child so that’s what we’re trying to avoid.”

Governor Mike Parson (R) in his State of the State Address earlier this month said, “we are heartbroken to be failing,” in the area of infant mortality, with Missouri ranking 44^th in the nation for its “abnormally high” rate.

Kansas City Democrat Patty Lewis calls the situation, “abysmal.” She said in a Department of Health and Senior Services report covering 2017 to 2019, “Something that was pretty astounding to me based on their findings is 75-percent of the deaths are preventable. As [someone with a] background in nursing, if we can prevent something that’s what I want to do,” said Lewis.

She said in the years covered by the report an average of 61 women died while pregnant or within one year of pregnancy, with 68 in 2018.

“If we can just save one that would be great, but saving 60 women I think would be very important to me.”

Freshman representative Melanie Stinnett (R-Springfield) said maternal healthcare was an issue that voters talked to her about leading up to her election in November.

“I work in the realm of healthcare and I work with a lot of families with children with disabilities, specifically, but also work really closely with organizations like The Doula Foundation and midwife groups in Springfield so it’s certainly something that’s come up in Springfield and a topic that has been something that I’ve talked about in our community,” said Stinnett.

Representative Brad Pollitt (R-Sedalia) said the data about how many of those deaths could have been prevented weighs heavily on him.

He said the proposal, “is just giving a little extra healthcare to get them off on the right foot and to help the mother who may be having issues and I just think it’s the right thing to do.”

“It’s not the state’s job, it’s not the taxpayer’s job to financially take care of every individual from birth to death. That’s not what this is doing. This is giving someone an opportunity to start off on a better life and if we can do that then I just think it’s the right thing to do and I think it shows that we do care as a party about life after the baby’s born, and about the mother’s life.”

The Republican sponsors of the bill acknowledge that it also relates to their party’s identity regarding its pro-life stance. Bishop Davidson (R-Republic) said his party is often criticized as only supporting life before birth, but this bill is one thing that demonstrates otherwise.

“We carried it before that Dobbs case. We’re going to carry it after that Dobbs case. We’re interested in lives, and lives being fulfilled from conception to death, and so I see this piece of legislation as a part of a holistic agenda that is pro-life.”

Representative LaKeySha Bosley (D-St. Louis), who is for the fourth time sponsoring this proposal, says that it is “imperative” after Dobbs, “as we did pass the abortion ban, and [even] before we passed House Bill 126, the heartbeat bill, women who were in rural or underserved communities were dying [in] childbirth.”

Patterson agrees with his fellow Republicans, “We’re a pro-life state. I’m very proud to be pro-life, but that also means taking care of these children that are born. This is a measure that would ensure that the mother has healthcare for a year after they’re born, which is critically important to the wellbeing of the newborn baby.”

*Representative Brad Pollitt (Photo: Tim Bommel, Missouri House Communications)*

Bosley notes that while maternal mortality rates are an issue statewide, they hit some in Missouri harder than others.

“As an African American woman, as a minority in the State of Missouri … women who look like me are dying at a higher number and at a higher rate than our white counterparts.”

Bosley is glad that this proposal has gained more sponsors and a lot of media attention and she hopes it will lead to more.

“I’m happy that it’s a hot topic. Let’s go further than just the 12^th months. Let’s talk about doulas. Let’s go into the holistic conversation about how we can provide some assistance to doulas and have them be reimbursed,” adding, “Extending the coverage from the three months to the twelve months is just one of the small things that we can do, and it may seem small but it’s going to mean so much to a lot more people across the state.”

*Representative Bishop Davidson (Photo: Tim Bommel, Missouri House Communications)*

Patterson observes that the broad appeal of this plan isn’t limited to the House but extends to the Senate, where two versions have been filed and have already received a hearing. He and the other sponsors share great optimism that this will pass this year.

“It’s just a common sense measure that we can do to ensure the health of the babies.”

None of the House versions of this bill have been referred to a committee.

The bills that have been filed are: House Bill 91 (Patterson), House Bill 254 (Pollitt), House Bill 286 (Lewis), House Bill 328 (Bosley), House Bill 354 (Davidson), and House Bill 965 (Stinnett).