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At issue is the renewal of a special tax on hospitals, nursing homes and other health care providers that the state relies upon to fund the $12 billion Medicaid program.

The Federal Reimbursement Allowance, known as the FRA, provides about $4.3 billion of the cost of the health insurance program for low-income Missourians.

But, Missouri Right to Life President Susan Klein wants lawmakers to add language barring the state from allowing Medicaid funds to reimburse Planned Parenthood for services like birth control, sexually transmitted disease treatments and cancer screenings.

It mirrors an unsuccessful attempt from three years ago when Gov. Mike Parson had to call lawmakers into a special session to approve the funding package without the anti-abortion provisions.

During a sometimes tense hearing of the Senate Appropriations Committee, Klein acknowledged that abortion is already banned in Missouri, but that Planned Parenthood clinics in the state are part of a national organization that provides abortions in states where the procedure is not prohibited.

“We’re asking for you to stop funding Planned Parenthood in the state,” Klein said. “We ask that you protect these pre-born babies.”

But, senators on both sides of the aisle bristled at Klein’s insistence on tying the Planned Parenthood provisions to the FRA because of concerns it could be challenged in court, where the issue has already been litigated.

“What you’re doing is not factual,” said Sen. Brian Williams, D-University City. “What about every other f—-ing issue in this state. You care about one issue. We have to stop allowing people like you from hijacking the process.”

Williams apologized for breaching Senate protocol, saying he was “grumpy” because he has been getting up at night to change diapers on his 10-month-old child. He later walked out of the hearing visibly angry.

Williams was joined in his criticism of Klein by Sen. Mike Cierpiot, R-Lee’s Summit, who accused her of trying to score points for her supporters, rather than work toward compromises.

“This has nothing to do with abortion. This is not about money, this is about a letter-writing campaign,” Cierpiot said.

Sen. Sandy Crawford, a Republican from Buffalo, urged Klein to find another vehicle to attach her anti-Planned Parenthood language in order to preserve the funding.

“This has gotten way out of hand,” Crawford said. “I just think your thinking is flawed.”

Although Sen. Denny Hoskins, R-Warrensburg, defended Klein’s tactics, he acknowledged the meeting had become emotional.

“This whole committee hearing has gone downhill fast,” Hoskins said. “This is pathetic.”

Sen. Lincoln Hough, R-Springfield, who is sponsoring the renewal of the tax, said he expects the panel to formally vote on the matter Thursday, which would allow it to be brought to the full Senate next week.

The hope is to move the measure to the House, which is in the midst of drafting a spending plan for the fiscal year beginning July 1.

In tallying up the potential financial damage if the FRA is not approved or is challenged in court, Gov. Mike Parson’s administration said failing to approve just the hospital tax portion of the measure would require major cuts to other state programs.

“If this proposed legislation does not pass, additional (general revenue) funds of $1.22 billion would be needed per year to continue the current level of services,” the administration reported.

The legislation notably does not include an expiration like it has in previous years, which could prevent the legislative renewal process from becoming embroiled in political debate in future years.

Hoskins, who is a candidate for secretary of state, wants an expiration date to give lawmakers an option to debate the tax in the future.

“I think it does give us the opportunity to ask questions and hold some feet to the fire,” Hoskins said.

A parade of lobbyists for the health care industry called on the committee to renew the tax without the anti-abortion language.

“We have deep concerns about the potential for the provider tax to lapse,” said Rob Monsees of the Missouri Hospital Association. “The addition of this to this bill could potentially cause some problems.”

Failing to renew the tax could lead to more hospitals closing, especially in rural parts of the state.

“It would be devastating,” Monsees said.

Sen. Jason Bean, R-Holcomb, said hospital closures could lead to longer travel times during medical emergencies Bootheel-region district.

“I don’t want to be an hour and fifteen (minutes) out,” Bean said.

Nikki Strong, a lobbyist for the state’s nursing homes, said failure to renew the tax could also lead to nursing home closures like the Dec. 15 closure of Northview Village Nursing Home in ӣ����Ƶ.

“If this does not renew, we’ll be out of business,” Strong said. “Without this funding, we’re done. Period.”

Sen. Karla May, D-ӣ����Ƶ, said the closure of the nursing home was massively disruptive to the 200 residents and their families.

“It is a crisis and we do have to look at the totality of life,” said May, who is running for the U.S. Senate.

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