2026 Missouri Legislative Session Recap
Missouri’s 2026 legislative session ended May 15. Lawmakers completed the FY 2027 budget on time, and importantly, the budget preserved Medicaid funding and core health program funding.
Because the session has adjourned, bills delivered to the governor are now in the post-session review period. Governor Mike Kehoe may sign, veto, or allow legislation to become law without his signature.
We’re providing this end of session recap to keep you informed on key legislative developments that may affect care and access in the communities we serve.
Budget
The General Assembly finalized the FY 2027 state budget and sent the spending bills to Governor Kehoe for review. The overall budget package totals approximately $50.7 billion, while the operating budget for HB 2002 through HB 2013 totals $48.7 billion, including about $15.5 billion in general revenue, and relies on $2.3 billion in surplus funds.
The budget largely preserves core Medicaid and health agency funding for the coming fiscal year. However, the use of one-time surplus funds significantly reduces the state’s fiscal cushion and signals that Medicaid, provider reimbursement, and other health-related spending may face greater scrutiny in the years ahead. The governor has until June 30 to sign or veto budget items.
Healthcare Omnibus
HB 2372 served as the final healthcare legislative package. The key provisions included in the final package include hospital service-area flexibility, community paramedic services, doula and childbirth education coverage, telehealth updates, hospital workplace violence signage, MO HealthNet reimbursement changes, 340B protections, anesthesia coverage limits, prior authorization updates, and price transparency enforcement language that could restrict debt collection for services provided during periods of federal noncompliance.
Language based on HB 1977 was included in the broader Healthcare Omnibus package. The provision streamlines the process for initiating 96-hour mental health holds by removing notarization requirements for applications and supporting documents completed by hospital staff, clinicians, and law enforcement. The language also clarifies that hospitals may act through employees when completing applications, without altering the legal threshold for detention.
HB 2372 passed the General Assembly and was delivered to Governor Kehoe on May 28, where it awaits action.
Certificate of Need
SB 1268, which sought to modify provisions relating to Certificates of Need (CON) did not advance during this session. The bill proposed removing hospitals and major medical equipment from Certificate of Need review, while maintaining requirements for long-term care hospital beds.
However, HB 2372 includes a narrower CON-related provision requiring the Missouri Health Facilities Review Committee to act when material facts were withheld or misrepresented in a CON application.
Statewide News
The Beacon News: Missouri lawmakers pass sweeping healthcare changes in 2026 legislative session
KMBC: Missouri Supreme Court upholds Gov. Kehoe’s authority to call special session
Howell County News: Governor won’t call gas tax special session, despite Durnell’s urging
