Weekly Legislative Update: No. 6

February 12, 2026

No. 6

WORKINGS OF THE WEEK

The House finished a second week of two-a-day sessions, giving initial approval to several bills and rounding out the week by sending a few bills on to the Senate. This week they dealt with nearly twenty bills – not bad for mid-February. They are whittling away at the 2,700 (and counting) bills filed so far this session.

The Senate worked into the evening for the first time on Wednesday, tackling intoxicating hemp. Senate Bill 904 updates Missouri’s cannabis laws by strengthening patient privacy protections and including regulation of intoxicating hemp‑derived products under the state’s existing marijuana framework. Not surprisingly, they ended up putting the bill back on the calendar when a compromise couldn’t be reached.

LET’S TALK ABOUT MONEY

The budget for graduate medical education (GME) funding, like everything else, is facing significant cuts this session. We are so thankful to the legislature for the previous commitment from general revenue to create and support new residency programs and slots. As it stands, the Governor is recommending a total reduction of $3.3 million from our $12 million program. We are hopeful to have some of the cuts restored as the budget winds its way through the sausage-making process. We need legislators to continue their commitment to growing the physician pipeline for our state. We’ll keep you in the loop.

DEATH OF/AND TAXES

We’ve all heard the old adage: Two things in life are certain—death and taxes. Well, it seems like that might be at risk of becoming a reality for healthcare. Missouri, at the direction of the Governor, is pondering becoming the 10th state in the nation to eliminate income taxes and replace that revenue with an increased sales tax. Bills have been filed that would send a measure to voters to do just that. Missouri’s constitution requires voter approval for such things. During the State of the State address, the Governor insisted on this change, with the caveat that there would be exemptions for agriculture, real estate and healthcare. Those promises, however, do not match the language of the bills (SJR 115 and HJR 174) making their way through the process. In fact, they do not include any exemptions. The Governor told a large group of stakeholders this week that the tax bill he signs will not have any carveouts because he does not want to get into a situation where everyone is asking for an exemption. Instead, he is asking everyone to trust the process and to trust him.  He is standing by his commitment of no new taxes on healthcare, agriculture, or real estate. Many people under the dome are skeptical at best this can be done. We are keeping a watchful eye on this sticky wicket.

PA COMPACT DELAYED

We raised serious concerns over the physician assistant (PA) compact bill that was heard last week in the House Professional Registration Committee. House Bill 3129 received enough scrutiny from committee members (and the bill sponsor) this week to delay the vote in committee. As drafted, the compact would override Missouri’s existing laws, weaken state oversight, and shift regulatory authority from the Board of Healing Arts to a multi‑state commission.  This commission could enact rules that would supersede Missouri statutes, limit our ability to discipline PAs, and even allow the commission to sue state boards. We are also concerned because it creates pathways for scope‑of‑practice expansion without legislative approval, pressures states to broaden PA authority during emergencies, and suspends conflicting Missouri laws—an extraordinary surrender of state sovereignty. Several provisions would undermine Missouri’s physician‑led regulatory framework. The bill also makes it easier for a future PA rebrand as “physician associates.” Thanks to our engagement, the committee has paused movement on the bill while we work to address these concerns. We have some good amendments circulating and expect a vote next week.

PHYSICIANS IN EMERGENCY DEPARTMENTS

On Wednesday, the House Professional Registration Committee heard HB 2557, filed by Rep. George Hruza, MD. This is a straightforward bill that simply states that a physician must be on staff and present in an emergency department (ED) when the department is open. Having a physician physically on duty whenever an ED is open is fundamental to patient safety. Patients expect it. When a patient arrives in crisis—stroke, sepsis, trauma, cardiac arrest—there is no substitute for the depth of training and clinical judgment that only a physician brings. Rural Missourians deserve timely access to a physician when minutes truly matter. The hospitals are predicting passage would lead to facility closures, even though this hasn’t been the case in other states that have passed similar legislation. This bill meets the expectation that an emergency department is staffed by the professionals most qualified to manage emergencies, and it puts patient safety at the center of Missouri’s emergency care system.

PRIOR AUTH COMING UP

We’ve been told to be ready to throw down with the insurance goons on Tuesday, March 3. The House Health and Mental Health Committee plans to hear HB 3010, our prior authorization reform bill. This important legislation takes direct aim at insurance companies’ overuse of prior authorization. Their abuse has grown so onerous and intrusive that it now functions as de‑facto medical decision‑making by insurers rather than physicians. Every day, doctors watch patients suffer delays, denials, and dangerous care interruptions because insurers hide behind layers of red tape designed to avoid paying for medically necessary treatment. This bill is a critical step toward returning the practice of medicine to physicians. We need physicians across Missouri to stand with us and push back against insurers who have turned prior authorization into a profit‑protecting weapon that undermines patient care. March 3rd is Physician Advocacy Day, so we hope everyone was planning on coming anyway. If not, register today and come to Jefferson City to not only advocate for yourself and patients, but to see first-hand the insurance industry’s attempts to legitimize these practices!

PHYSICIAN ADVOCACY DAY – REGISTER FOR THE PRE-PARTY ZOOM

Physician Advocacy Day is Tuesday, March 3, if you have not done so already, please using the link at the top of this webpage. We will be hosting a Zoom videoconference to discuss logistics and prepare everyone for our big day on Sunday, March 1, at 6:00pm. You can register for the Zoom here.