Weekly Legislative Update

January 8, 2026

No. 1

And They’re Off

The Missouri Legislature reconvened at high noon on Wednesday to begin the Second Regular Session of the 103rd General Assembly. Lawmakers returned to a session marked by transition, uncertainty, and unusually high expectations. Both chambers gaveled in with renewed energy. The Senate, however, also returned with familiar tensions. You might remember the Senate had to utilize several procedural motions called previous questions (PQ) to force votes on two contentious bills during the final day of last session. Legislative leaders for both Chambers delivered their final opening‑day speeches.

Speaker Jon Patterson, MD and Senate President Pro Tem Cindy O’Laughlin outlined their agendas for the year. Speaker Patterson has emphasized that improving the mental health of Missouri’s children must be an urgent priority. Pediatric mental health concerns have escalated nationwide, and Missouri is no exception. Physicians, school leaders, and families have all expressed alarm about rising rates of anxiety, depression, and behavioral health challenges among young people. We’re here for him and he knows it.

Senator O’Laughlin has indicated that one of her top priorities will be addressing the rapid expansion of large‑scale solar projects across Missouri. She also said that the Senate is not worried about the volume of bills that they pass this session but instead will focus on bills that matter for Missouri. Most of the hallway walkers believe her statement might be little foreshadowing of the challenges she anticipates are to come in the Senate.

The Governor has made clear that he intends to pursue a major restructuring of Missouri’s tax system, with the goal of making the state the tenth in the nation to eliminate the personal income tax. He has argued that doing so would improve Missouri’s competitiveness and attract new residents and businesses.

However, the path to such a change is complex. The State Auditor’s recent report raised questions about the long‑term sustainability of the current tax structure, particularly in light of last session’s repeal of the capital gains tax. 

For health‑related agencies and programs, the stakes are high. Any significant shift in revenue sources could affect funding for Medicaid, behavioral health services, public health infrastructure, and medical education programs.

Bills are Moving

The first week of Session is always brief, but this week they still got a lot done in their legislative process. Since leadership and committees are already established from last session, they wasted no time reading in bills and making committee assignments. On Wednesday the House and Senate read in over 1800 bills between the two Chambers. Before heading home for the week on Thursday, Speaker Patterson swiftly referred nearly 200 of the House’s more than 1200 bills to committee. We could see hearings next week! 

Our Highlights and Lowlites

One of our top priorities is a renewed push for prior authorization reform, SB 897 filed by Sen. Ben Brown. We nearly passed it last year. We’re optimistic about finally getting meaningful relief for physicians and patients navigating unnecessary administrative hurdles.

We’re also advancing title protection in healthcare settings in HB 2556 filed by Rep. Cathy Jo Loy. This effort is all about patient clarity and safety. Too often, non‑physician providers use titles that blur the lines for patients, especially in hospitals and clinics. Our goal is simple: in clinical settings, patients deserve to know exactly who is providing their care. Alongside this, we’re supporting legislation to reform physician non‑compete agreements in nonprofit hospital systems—an important step toward improving physician mobility and retention across Missouri.

Physician non‑compete agreements are also drawing long‑overdue scrutiny. In many communities—especially rural and underserved areas—these covenants restrict a physician’s ability to continue caring for their patients if they change employers, move within a certain radius, or seek a more sustainable practice environment. The result is reduced access, longer wait times, and a workforce that feels trapped rather than supported. Eliminating or reducing these restrictive agreements in nonprofit hospital systems is a practical, pro‑patient reform. It keeps physicians in Missouri, strengthens continuity of care, and ensures that employment contracts never stand between patients and the doctors they trust.

We expect insurance reform to be front and center after all of last year’s efforts were traded away so that Farm Bureau could sell a health insurance product. House Bill 1944, sponsored by Rep. George Haruza, MD, tackles several problematic insurer practices, including attempts to impose time limits on anesthesia coverage and proposals to charge physicians and hospitals fees for going out of network. This bill represents a strong, physician‑led effort to push back against policies that undermine patient care and clinical judgment.

As always, scope of practice battles will consume a significant share of our attention. APRN and CRNA independent practice, optometric surgery, naturopathic licensure, pharmacy prescribing expansions, and assistant physician scope changes are all back on the docket. While many of these proposals are familiar, the volume and intensity continue to grow. We’re also supporting a narrow, physician‑aligned optometry bill that simply codifies current practice—an important strategic tool in opposing more expansive scope efforts.

Beyond these core issues, we’re tracking several other notable bills: new disclosure requirements for physicians, emergency department staffing standards, legislation on ivermectin and hydroxychloroquine, large healthcare omnibus bills resurrected from last year, and Missouri’s commitment—through the Rural Health Transformation Program—to consider a physician assistant compact. Add in election‑year politics and a surge of bills on gender‑related care, and it’s clear this session will require constant vigilance. 

Help Us Help You

Be sure to mark your calendar for Physician Advocacy Day on Tuesday, March 3, 2026. This is our big, unified lobby day where we show, in no uncertain terms, that Missouri physicians are engaged, organized, and paying attention. Bring your white coat. Legislators call it “white coat day,” and when they say it, we know we’ve made an impression.

If you’d rather visit with your legislators one-on-one on a day other than March 3rd, let us know. We can arrange meetings for you with some advance notice. Tuesdays and Wednesdays are the best days to catch legislators in their offices. If interested in a personal visit, contact Brian Bowles at brianb@maops.org for assistance. 

Committee schedules for both the House and Senate are already set. Most of the bills we’re tracking will land in committees meeting on Tuesday, Wednesday and/or Thursday mornings. If you’re interested in testifying or want to be looped in when specific bills are up, reach out to Brian. Your voice carries weight—let’s make sure it’s heard.