Healthcare (Medicaid)

HJR 154 proposes a constitutional amendment requiring work requirements for Missouri's MO HealthNet program (state Medicaid) for certain adults. It would affect individuals aged 19-65 who qualify under federal Medicaid rules (income at or below 133% of the federal poverty level), are not pregnant, disabled, or enrolled in other federal health programs. The bill mandates documentary proof of work compliance at application and monthly to maintain coverage, prohibits self-attestation, and requires state plan changes to implement this by 2027. It does not change income eligibility thresholds but adds a new administrative requirement for this specific group.

HB 3106, titled the "End Organ Harvesting Act of 2026," would prohibit Missouri health benefit plans (including MO HealthNet and Medicaid managed care) from covering organ transplants or post-transplant care under two specific circumstances: (1) if the transplant occurs in China, or (2) if the organ was procured through sale or donation originating in China. This bill directly affects health insurers and plans operating in Missouri by restricting coverage for these transplant scenarios. The key provision is a blanket coverage ban for transplants tied to China, as defined in the bill's text. The bill was introduced in the Missouri House on January 27, 2026, and is pending further action.

HB 2874 creates rules for air ambulance membership plans, which are non-insurance programs that let people pay for air ambulance services in advance. It directly affects Missouri residents enrolled in MO HealthNet (Missouri's Medicaid program), as these individuals cannot purchase or renew such memberships. Key provisions require membership organizations to: (1) stop selling to MO HealthNet enrollees, (2) offer a partial refund or transfer if someone joins Medicaid during their membership, and (3) clearly state in all marketing and applications that the plan is not insurance and Medicaid beneficiaries are ineligible. The bill also mandates specific disclosures about Medicaid ineligibility and prohibits marketing to Medicaid members. Violations can be reported to the state Attorney General for enforcement.

HB 2309, titled the "End Organ Harvesting Act of 2026," prohibits Missouri health insurance plans and Medicaid programs (including MO HealthNet and Medicaid managed care) from covering organ transplants or post-transplant care under two specific conditions: if the transplant occurs in China, or if the organ was obtained through sale or donation originating in China. The bill directly affects health insurers, patients seeking transplants involving China, and healthcare providers billing these insurers. Key provisions require health carriers to deny coverage for transplants meeting either of these China-related criteria. This is a policy change restricting insurance coverage for specific transplant scenarios, not a procedural measure.

HB 1945 modifies Missouri's health care payment system for clinical pathology services under MO HealthNet (the state's Medicaid program). It requires MO HealthNet to pay hospital-based pathologists 30% of Medicare's rate for the "professional component" of their services (interpretation and diagnosis), with payments going directly to the hospital if the pathologist is employed there, or to the third-party provider if not. This affects hospitals, pathologists, and MO HealthNet patients by standardizing reimbursement for these diagnostic services. The bill also adds licensing requirements for drug distributors (section 338.333), but the primary focus is on pathology billing changes.

HB 2582 requires applicants for Missouri's MO HealthNet program to verify they are not enrolled in another state's Medicaid program or a qualified health plan under the Affordable Care Act. It directly affects individuals seeking MO HealthNet benefits who currently have coverage elsewhere, including those relocating from other states. The bill mandates applicants provide a certificate of non-enrollment from their previous state program if applicable, and requires them to terminate that enrollment before MO HealthNet approval can be granted. This change adds a verification step to the application process without altering existing eligibility criteria for MO HealthNet.