COMMITTEE ON LEGISLATIVE RESEARCH OVERSIGHT DIVISION FISCAL NOTE L.R. No.:5500H.02C Bill No.:HCS for HB 2634 Subject:Health Care; Abortion; Medicaid/MO HealthNet Type:Original Date:February 22, 2024Bill Summary:This proposal modifies provisions relating to public funding of abortion facilities and affiliates and provisions relating to MO HealthNet providers. FISCAL SUMMARY ESTIMATED NET EFFECT ON GENERAL REVENUE FUNDFUND AFFECTEDFY 2025FY 2026FY 2027Total Estimated Net Effect on General Revenue $0$0$0 ESTIMATED NET EFFECT ON OTHER STATE FUNDSFUND AFFECTEDFY 2025FY 2026FY 2027Total Estimated Net Effect on Other State Funds $0$0$0 Numbers within parentheses: () indicate costs or losses. L.R. No. 5500H.02C Bill No. HCS for HB 2634 Page 2 of February 22, 2024 KP:LR:OD ESTIMATED NET EFFECT ON FEDERAL FUNDSFUND AFFECTEDFY 2025FY 2026FY 2027Total Estimated Net Effect on All Federal Funds $0$0$0 ESTIMATED NET EFFECT ON FULL TIME EQUIVALENT (FTE)FUND AFFECTEDFY 2025FY 2026FY 2027Total Estimated Net Effect on FTE 000 ☐ Estimated Net Effect (expenditures or reduced revenues) expected to exceed $250,000 in any of the three fiscal years after implementation of the act or at full implementation of the act. ☐ Estimated Net Effect (savings or increased revenues) expected to exceed $250,000 in any of the three fiscal years after implementation of the act or at full implementation of the act. ESTIMATED NET EFFECT ON LOCAL FUNDSFUND AFFECTEDFY 2025FY 2026FY 2027Local Government$0$0$0 L.R. No. 5500H.02C Bill No. HCS for HB 2634 Page 3 of February 22, 2024 KP:LR:OD FISCAL ANALYSIS ASSUMPTION §§188.015, 188.207, 188.220, 208.152, 208.153, 208.164, and 208.659 - Relating to public funding of abortion facilities and affiliates In response to a previous version, officials from the Office of Attorney General (AGO) assumed any potential litigation costs arising from this proposal could be absorbed with existing resources. However, the AGO may seek additional appropriations if the proposal results in a significant increase in litigation or investigation. Oversight does not have any information to the contrary. Therefore, Oversight assumes the AGO will be able to perform any additional duties required by this proposal with current staff and resources and will reflect no fiscal impact to the AGO for fiscal note purposes. In response to a previous version, officials from the Office of Administration - Budget & Planning (B&P) stated this bill had no direct impact on B&P or on general and total state revenues. The B&P states it will not impact the calculation pursuant to Article X, Section 18(e). Officials from the Department of Social Services, the Department of Commerce and Insurance, the Department of Health and Senior Services, the Department of Mental Health, the Office of Administration – Administrative Hearing Commission the Office of the State Courts AdministratorNewton County Health Department each assume the proposal will have no fiscal impact on their respective organizations. Oversight does not have any information to the contrary. Therefore, Oversight will reflect a zero impact in the fiscal note for these agencies. Oversight only reflects the responses received from state agencies and political subdivisions; however, other local public health agencies and hospitals were requested to respond to this proposed legislation but did not. A general listing of political subdivisions included in Oversight’s database is available upon request. Rule Promulgation Officials from the Joint Committee on Administrative Rules assume this proposal is not anticipated to cause a fiscal impact beyond its current appropriation. Officials from the Office of the Secretary of State (SOS) note many bills considered by the General Assembly include provisions allowing or requiring agencies to submit rules and regulations to implement the act. The Secretary of State's office is provided with core funding to L.R. No. 5500H.02C Bill No. HCS for HB 2634 Page 4 of February 22, 2024 KP:LR:OD handle a certain amount of normal activity resulting from each year's legislative session. The fiscal impact for this fiscal note to Secretary of State's office for Administrative Rules is less than $5,000. The Secretary of State's office recognizes that this is a small amount and does not expect that additional funding would be required to meet these costs. However, they also recognize that many such bills may be passed by the General Assembly in a given year and that collectively the costs may be in excess of what their office can sustain with their core budget. Therefore, they reserve the right to request funding for the cost of supporting administrative rules requirements should the need arise based on a review of the finally approved bills signed by the governor. FISCAL IMPACT – State GovernmentFY 2025FY 2026FY 2027$0$0$0FISCAL IMPACT – Local GovernmentFY 2025FY 2026FY 2027$0$0$0 FISCAL IMPACT – Small Business No direct fiscal impact to small businesses would be expected as a result of this proposal. FISCAL DESCRIPTION The proposed legislation appears to have no direct fiscal impact. This bill has an emergency clause. This legislation is not federally mandated, would not duplicate any other program and would not require additional capital improvements or rental space. SOURCES OF INFORMATION Attorney General’s Office Department of Commerce and Insurance Department of Health and Senior Services Department of Mental Health Department of Social Services L.R. No. 5500H.02C Bill No. HCS for HB 2634 Page 5 of February 22, 2024 KP:LR:OD Joint Committee on Administrative Rules Office of Administration Budget and Planning Administrative Hearing Commission Office of the Secretary of State Office of the State Courts Administrator Newton County Health Department Julie MorffRoss StropeDirectorAssistant DirectorFebruary 22, 2024February 22, 2024