Mo. Governor Enacts Midwives Law as Part of Insurance Bill

June 4, 2007

Gov. Matt Blunt signed legislation on June 1st that started out expanding health insurance options and ended up, unbeknownst to most lawmakers, legalizing midwifery.

Under current Missouri law, midwifery is a felony crime, punishable by up to seven years in prison, when practiced by anyone other than certain nurses working in collaboration with physicians.

The provision that Sen. John Loudon slipped into the health insurance bill allows midwives certified by private groups to legally work in Missouri. After sending the bill to the governor, some legislators worked to undo the language, or pass the insurance part separately, but those efforts failed.

On June 1, Blunt spent most of the day highlighting a separate bill increasing fire safety requirements at long-term care facilities in response to a fatal fire last year.

But Friday afternoon, his office provided less than two hours’ notice of a health care news conference in Kearney without saying the purpose.

About an hour after the event, and only after another organization sent out a news release, Blunt’s office announced he had signed the legislation.

Much as Loudon did when passing the bill, Blunt’s news release made no mention that the health insurance legislation also contained the midwifery provision.

Asked why not, Blunt spokeswoman Jessica Robinson replied: “The part of the bill we’re highlighting is the health insurance provision.”

The underlying health insurance bill provides tax credits for people who buy their own health insurance. The idea is to put those people on the same level as employees of larger businesses whose health insurance premiums are deducted from paychecks before taxes.

“This bill is a good step towards expanding access to care for Missourians currently without insurance,” Blunt said in a written statement after an event in the hometown of the insurance measure’s sponsor, Republican Rep. Doug Ervin.

The bill also lets people keep their individual health insurance policies when they take a job with a small business that provides a group health plan. Instead of paying for that employee’s participation in the group plan, the business would pay an equivalent amount that could be used for the individual insurance premium.

In addition, the legislation expands eligibility and lowers premiums for people covered by the Missouri Health Insurance Pool. The government-supervised program provides private insurance to people who cannot get or afford it, generally because of chronic health problems.

The bill also allows the state to deduct private medical debts from people’s income tax returns and lottery winnings, another section that caused concerns among some lawmakers.

Loudon also inserted language requiring the state to establish a clearinghouse of information about support services for pregnant women who learn their unborn children could have Down syndrome or other conditions.

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