May 8, 2026
No. 17
BUDGET IS SET
The House and Senate dedicated most of the week to finalizing the budget. Monday was spent on conference committee work. Once agreements were struck in conference, the chambers volleyed the budget bills to each other, giving final approval late on Wednesday. Our graduate medical education program received $7.5 million in funding for the 2027 fiscal year. The budget is in the hands of the Governor two days ahead of its constitutional deadline for passage. Unlike policy legislation, the Governor can use the line-item veto on the budget bills, so nothing is truly safe until he signs it. We’ll be watching closely.
HOUSE LOVING ON BILLS
On Tuesday, the House worked for hours on SB 1421 which would regulate the use of drones. The bill took on over 40 amendments before the legislative love fest ended and the bill was approved. Though not completely germane to the bill, a few of the more creative amendments were related to healthcare: modifying the amounts of pseudoephedrine which may be purchased; updating statutes for passenger restraints for children and regulations for children riding as passengers on motorcycles.
This is typical for the final days of the session when legislators start throwing their legislation on everything with the hopes it will cling. Those amendments are at risk of being cleared off with a spritz of washer fluid and one swipe of a wiper in the conference committee.
BORN-ALIVE PASSES THE SENATE
Tuesday was a busy day in the Senate as well. In between working on bills that were part of a legislative compromise for votes on the budget and tax reform ballot measure, they worked at length to give initial approval to a slightly watered-down SB 999. The Senate’s revised Born-Alive Abortion Survivors Protection Act removes sweeping civil liability provisions that could have exposed physicians to lawsuits over medication abortions, including in cases of early-induction for fatal fetal diagnoses. That change is significant because the original language risked criminalizing evidence-based care and forcing clinicians to practice under legal ambiguity rather than medical standards. The new version still requires providers to offer appropriate care to any infant born alive after a failed abortion, but it avoids the broad legal exposure that doctors warned would create “confusion and chaos” in clinical decision-making. The bill also expands Missouri’s maternal mortality review board. The bill passed the Senate quickly on Wednesday once they disposed of the budget. Now the bill will move to the House with one week left. Keep in mind it must go through their committee process, floor debate, and approval. If they make any changes, it must return to the Senate. Another caveat to consider on this subject is that the Senate has been in possession of the House bill for weeks. Tick-tock, tick-tock.
ONMNIBUS LICENSURE BILL MOVES TO THE GOVERNOR
An omnibus licensure bill, SB 1233, was given final approval earlier today. This bill extends temporary licenses to professionals from other states to work in Missouri, except for all professionals with an interstate compact, and physician assistants. It also has the telehealth licensure reciprocity language, which was already passed and sent to the Governor a couple of weeks ago. The bill has several pharmacy-related provisions. One will allow pharmacists to administer several vaccines. We had the big ones excluded. It will also allow for Missouri pharmacies to waive compliance for shipping prescription drugs to other states when that state is experiencing a state-declared emergency or disaster. Furthermore, it will establish a pathway to licensure for wholesale drug distribution from other states. This bill is on its way to the Governor.
WHERE’S THE GOALIE?
Many Capitol denizens think the Senate has functioned differently this year. After years of chaos and complete dysfunction, the pendulum seems to have swung too far in the opposite direction – less methodical deliberation on the issues. This year, they functioned more like the House, with very little resistance to any bills or amendments unless heavily prodded. They have been very agreeable and sometimes apathetic as we enter the final week of session. Both of the healthcare omnibus bills (HB 2371 and SB 841) are in play, as well as the weakened pharmacy scope expansion in SB 878 and expanded access to psychedelic drugs in HB 1717.
WRAP UPS
We’ll be too busy to write a report for you next week. You’ll get a “5 Things” next Monday morning, and you’ll get a final Legislative Report on Monday, May 18. Make sure you register for the End of Session Recap Zoom, which we’ll host on Sunday, May 17, at 6:00 pm.