HB 2146 Missouri House · 2026 Regular Session

Modifies provisions relating to the operation of, and investment of moneys by, certain hospitals

HB 2146 increases the investment limit for certain hospitals from 25% to 50% of their non-essential funds (funds not needed for immediate operations). Hospitals meeting specific criteria - receiving less than 3% of annual revenue from government taxes and less than 3% from local government appropriations - can now invest in mutual funds, high-rated bonds (with short maturities), money-market funds, or combinations of these. The bill requires remaining funds to be invested in ways permissible for the state treasurer. This change modifies existing investment rules for hospitals organized under Missouri's Chapter 96, 205, or 206.

Bill status passed 3 of 5 stages cleared

Introduction

Dec 2025

Committee Review

May 2026

House Passage

Mar 2026

Senate Passage

Governor

Introduced Dec 3, 2025 Last action May 7, 2026

Maddy AI version diff · 2 comparisons

What changed between versions

Senate Committee Substitute → Perfected · 5 edits

MODERATE

The bill was refined from a broad healthcare reform package to a focused hospital-specific act. The scope was narrowed to repeal only three sections (96.192, 96.196, and 206.110) instead of five, and the new sections enacted now specifically address hospital investment rules and operational powers rather than including pharmacy or other unrelated statutes. This change clarifies the legislation's intent to modernize hospital governance and investment authority without altering laws regarding controlled substance dispensing.

Scope change

The bill's scope was significantly narrowed from covering hospital, pharmacy, and other health-related statutes to focusing exclusively on hospital organization, investment strategies, and operational powers.

SCOPE

Repealed sections 195.417 and 579.060 were removed, eliminating the bill's previous coverage of pharmacy limits on cold medicine sales and other unrelated statutes.

The enacted sections were reduced from seven to four, removing provisions related to pharmacy operations and replacing them with a new section (206.158) focused on hospital district powers.

REQUIREMENT

Hospital investment rules were updated to allow up to 50% of funds in mutual funds, bonds, or money-market investments, replacing previous restrictions on specific investment types.

ELIGIBILITY

Eligibility criteria for hospital investment rules were adjusted to require that less than 3% of revenue comes from taxes or municipal appropriations, replacing the previous 1% threshold.

Restrictions on hospital expansion into counties with existing facilities were clarified to exclude references to chapters 205 or 206, narrowing the definition of competing facilities.

Floor votes

How they voted

This bill passed the House by voice vote (no roll call recorded).

Full legislative history

Actions timeline

Total actions

Key actions

Committee

May 7, 2026

Upper · Passed

Reported Do Pass (S)

upper

May 7, 2026

Upper · Passed

Voted Do Pass (S)

upper

May 5, 2026

Committee

Referred: Fiscal Oversight(S)

upper

May 4, 2026

Upper · Passed

SCS Reported Do Pass (S)

upper

Apr 29, 2026

Upper · Passed

SCS Voted Do Pass (S)

upper

Mar 23, 2026

Committee

Second read and referred: General Laws(S)

upper

Mar 11, 2026

Lower · Passed

Third Read and Passed (H) - AYES: 143 NOES: 1 PRESENT: 3

lower

Feb 12, 2026

Lower · Passed

Reported Do Pass (H) - AYES: 9 NOES: 0 PRESENT: 0

lower

Feb 12, 2026

Lower · Passed

Voted Do Pass (H)

lower

Feb 5, 2026

Committee

Referred: Rules - Administrative(H)

lower

Jan 22, 2026

Lower · Passed

Reported Do Pass (H) - AYES: 12 NOES: 0 PRESENT: 0

lower

Jan 22, 2026

Lower · Passed

Voted Do Pass (H)

lower

Jan 8, 2026

Committee

Referred: Health and Mental Health(H)

lower

Dec 3, 2025

Introduced

Prefiled (H)

lower

1 primary · 1 co-sponsor