Subject: Health Care; Health, Public; Federal-State Relations; Insurance, Medical; Religion; Abortion

Bill Summary: Provides protections for religious beliefs as to the imposition of certain health care services such as abortion, contraception, or sterilization.

ESTIMATED NET EFFECT ON GENERAL REVENUE FUND
FUND AFFECTED	FY 2013	FY 2014	FY 2015


Total Estimated Net Effect on General Revenue Fund	$0	$0	$0

ESTIMATED NET EFFECT ON OTHER STATE FUNDS
FUND AFFECTED	FY 2013	FY 2014	FY 2015


Total Estimated Net Effect on Other State Funds	$0	$0	$0

ESTIMATED NET EFFECT ON FEDERAL FUNDS
FUND AFFECTED	FY 2013	FY 2014	FY 2015


Total Estimated Net Effect on All Federal Funds	$0	$0	$0

ESTIMATED NET EFFECT ON FULL TIME EQUIVALENT (FTE)
FUND AFFECTED	FY 2013	FY 2014	FY 2015


Total Estimated Net Effect on FTE	0	0	0

☐ Estimated Total Net Effect on All funds expected to exceed $100,000 savings or (cost).

☐ Estimated Net Effect on General Revenue Fund expected to exceed $100,000 (cost).

ESTIMATED NET EFFECT ON LOCAL FUNDS
FUND AFFECTED	FY 2013	FY 2014	FY 2015
Local Government	$0	$0	$0

Officials from the Office of Administration, Office of State Courts Administrator, Department of Insurance, Financial Institutions, and Professional Registration, Missouri Consolidated Health Care Plan, Missouri Department of Transportation, Missouri Department of Conservation, St. Louis County, City of Columbia, Lincoln University, Linn State Technical College, Metropolitan Community College, Missouri Southern State University, Missouri State University, Missouri Western State University, Northwest Missouri State University, University of Central Missouri, Parkway School District and Mexico School District assume the proposal will have no fiscal impact on their organizations.

Officials from the Department of Public Safety - Missouri State Highway Patrol defer to the Missouri Department of Transportation for response regarding the potential fiscal impact of this proposal on their organization.

Officials from the Department of Higher Education (DHE) state the proposal would have no direct, foreseeable fiscal impact on the DHE.

Officials from the City of Kansas City state that although no direct costs are incurred, there are indirect costs that may be incurred if the City chooses to include family planning services as well as abortion services in its employee benefits.

No governmental entity, public official, or entity acting in a governmental capacity shall discriminate against or penalize a health plan, plan sponsor, health care provider, employer, employee, or other entity or person because of such plan’s, sponsor’s, provider’s, employer’s, employee’s, entity’s, or person’s unwillingness, based on religious beliefs or moral convictions, to provide or obtain coverage for, participate in, or refer for, abortion, contraception, or sterilization in a health plan.”

A separate, second health policy for family planning and abortion services may be required if those benefits are to be continued. Limitations on benefits for that plan will, in all likelihood, result in higher premiums than a program that offered those services as part of its overall benefits package.

Officials from the Department of Social Services - MO HealthNet Division state this proposal provides that no employee or any other person, employer, health plan provider or sponsor, health care provider or any other entity shall be compelled to obtain coverage for or provide coverage for abortion, contraception, or sterilization in a health plan if such items or procedures are contrary to the religious beliefs or moral convictions of such employee, health care plan, provider or sponsor, or any other entity or person.

In the provider participation section of the fee-for-service provider manuals, a MO HealthNet provider must comply with all laws, policies, and regulations of Missouri and the federal government. It further states that a provider must also comply with the standards and ethics of his or her business or profession to qualify as a participant in the program.

The managed care contracts include language which prohibits the health plan from requiring a provider to perform a service contrary to the provider's conscience and allows the provider to make a referral to another health care provider licensed to provide the appropriate care. Therefore, there is no fiscal impact to MO HealthNet.

Officials from the Office of Attorney General and Office of Prosecution Services did not respond to Oversight’s request for a statement of fiscal impact.

No direct fiscal impact to small businesses would be expected as a result of this proposal.

This legislation is not federally mandated, would not duplicate any other program and would not require additional capital improvements or rental space.