JEFFERSON CITY — A bill extending substance abuse coverage through Medicaid for new moms will require lawmakers to get a federal waiver approving it.

The bill, House Bill 2280, would extend MO HealthNet coverage to include substance abuse treatment for up to a year after a woman gives birth.

Women are only covered for 60 days after their pregnancy. The limited treatment period results in a greater chance of relapse and overdose because of the reduced tolerance from when they were receiving treatment while pregnant.

“With all the talk about bending the curve on the opioid addiction crisis, this certainly is one piece of the puzzle,” said Rep. Marsha Haefner, R-St. Louis, the sponsor of the bill.

In a Senate committee hearing Tuesday, lobbyists and representatives from multiple health organizations testified in support of the bill. This was in addition to hours of testimony in support during a House committee hearing in February.

Senators also discussed the federal waiver the bill would require to be implemented as law.

Because the bill would carve out coverage for a specific portion of the population, a federal waiver would be required for the state of Missouri to be able to offer the program. That’s because Medicaid involves federal funding.

“We think the odds are good that CMS will give us the waiver and allow us to expand Medicaid for that population (of) the women that are suffering from addiction,” Rep. Martha Stevens, D-Columbia, said. Stevens had proposed a similar bill at the beginning of the session, which is now incorporated into HB 2280.

If approved, the federal government would provide about 60 percent of the funds, Haefner said.

Lawmakers expressed concern about the bill’s cost. The financial estimate attached to the bill states it would cost the general revenue fund just more than $1.5 million the first fiscal year, increasing to more than $4.3 million in fiscal year 2021. It also would cost an estimated $638,587 in federal funds in fiscal year 2021.

However, passage of the bill may end up saving money.

A program offered by Jordan Valley Community Health Center, which provided treatment to moms to keep babies out of the NICU, saved about $2.7 million, said Matt Stinson, a family physician and vice president of medical and behavioral health at the center.

“Extended treatment will result in a significant cost avoidance in both Medicaid and in our foster care system,” Haefner said. “We’re investing.”

The fiscal note estimated 1,236 women a year would be eligible to receive the coverage, which would include help with transportation, mental health coverage and primary care coverage. During the House committee hearing in February, it was emphasized that the bills should include all aspects of this coverage for it to be successful.

“One thing that really came out of that committee hearing is that new moms need not just substance use disorder treatment, (but) that we really need to have comprehensive background services, and so I’m very pleased that this bill is full Medicaid coverage,” Stevens said.

Stevens’ original proposal would have extended coverage for new moms under HealthNet and Show-Me Healthy Babies a year after giving birth. That bill was amended with two others to be included in Haefner’s bill.

While HealthNet remains in the bill, Show-Me Healthy Babies, which covers a population with slightly more income, was dropped and the coverage was limited to substance abuse treatment, not the overall coverage Stevens originally proposed.

While it may be more limited, Stevens and Haefner both view this bill as a starting point to extending coverage further.

Both were optimistic the bill would make it to the governor this session.

“This is good policy for the people of Missouri, and I’m hoping that all of the other noise going on in the building isn’t going to stand in the way of something that we can do to help,” Haefner said.

Supervising editor is Mark Horvit: horvitm@missouri.edu.

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