Legislature Squanders Health Care Opportunity
As has been discussed on this blog multiple times over the past few weeks, Missouri’s 2022 legislative session was largely a disappointing one. For me, the biggest letdown was the legislature’s failure to capitalize on the momentum for health care reform.
Since long before the COVID-19 pandemic began, my colleagues and I have written about the insufficient supply of health care providers in Missouri and offered a bevy of reforms that would help address the situation. Then, once the coronavirus arrived in the spring of 2020, Governor Parson waived a variety of laws and regulations that were needlessly inhibiting health care professionals from practicing in our state. While this was a positive step, waivers only offer temporary solutions to a permanent problem.
For the nearly 20 months after the waiver was first issued, state health care supply grew because of the reduction of unnecessary burdens. Thousands of Missourians tried telemedicine for the first time. Advanced practice registered nurses (APRNs) were allowed to navigate freely across the state to serve patients that needed care. And licensed health care providers from other states were allowed to come to Missouri and easily begin providing care.
While the services described above may not sound out of the ordinary, none of them were allowable under Missouri law prior to 2020. Telemedicine was largely restricted to patients and providers who had met previously in person. APRNs were only allowed to practice medicine within 75 miles of a collaborating physician. And finally, state professional registration boards were not required to recognize the licensure of many practitioners from other states, or at least not without first requiring them to clear too many unnecessary hurdles. Fortunately, Missouri’s legislature acted on that last item and approved interstate license reciprocity in 2020, which drastically improved the licensing process for out-of-state professionals interested in working in Missouri. Unfortunately, easy access to telemedicine and APRNs remained reliant on emergency waivers.
As I wrote less than a month ago, I was optimistic going into the 2022 session that reform was on the way. Missouri was turning the corner on COVID-19, and Governor Parson allowed the emergency order for the pandemic to expire, along with the health care waivers. Rarely is the opportunity for legislative action so apparent and uncontroversial; the legislature simply needed to enshrine the popular status quo from the past two years into law. Instead, health care reform was another victim of this year’s legislative dysfunction, leaving any hope for action once again to the future.