While many were focused last week on the Senate Appropriations Committee’s investigations into the handling of private information, the budgeting arm managed to zero out direct state funding for community health centers across the state that serve thousands of uninsured Missourians.
“I would say we were blindsided,” said Joe Pierle, chief executive officer of the Missouri Primary Care Association, which represents the federally qualified health centers. “We were told the money was going to be there.”
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Budget proposals from the House and the governor included funding for the centers.
During the Senate committee’s hearing Thursday, the change, which amounts to about $3 million to fund health care services for the poor, wasn’t discussed. Some committee members – Democrats and at least one Republican — said they were also surprised by the move.
Senate Appropriations Chair Kurt Schaefer, R-Columbia, said he thinks the network of health centers “serve a valuable function,” but some lawmakers want to look further into the amount of government funding they receive. He said he expects some – if not all – of the funding to be restored later in the budget process.
"We will go to conference and it will come out somewhere between us and the House," he said.
Schaefer noted that the Senate gets the budget last, which limits the opportunities that senators have to look into different spending categories.
“This is a year that we’re looking at FQHCs,” he said.
According to Schaefer, Sen. Rob Schaaf, R-St. Joseph, has expressed concern that the combination of Medicaid pay and “wrap around” pay the centers receive, and whether it gives the centers an edge over other health care providers who only get the Medicaid reimbursement rates.
“We’ve got some concerns,” Schaefer said. “The issue is, there seems to be a competitive disadvantage there and why is that appropriate?”
But Pierle said the hit came as a double-whammy to Missouri’s working poor. On the same day, the Senate Appropriations Committee closed the door on efforts to expand the state’s Medicaid program. Even though the expansion would be covered by federal dollars, state lawmakers have to appropriate the funds.
The Senate Appropriations Committee was originally scheduled to meet this evening, but the meeting was canceled.
The committee is scheduled to meet tomorrow.
Still ahead in the budget process:
The Senate Appropriations Committee will finalize its budget proposal this week and send it to the full chamber for approval.
Once the Senate adopts its version of the spending plan for the year that starts July 1, House and Senate leaders will meet to hash out a compromise.
The Legislature has until May 10 to pass a final budget.
Elizabeth Crisp covers Missouri politics and state government for the Post-Dispatch. Follow her on Twitter at @elizabethcrisp.
