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Missouri U.S. Rep. Jason Smith predicts resolution to federal spending fight

Congressman Jason Smith listens to attendees at a roundtable of health care professionals on Monday, Sept. 11, 2023, at Crystal City City Hall. Smith, R-Salem, is the chairman of the House Ways and Means Committee.
Jason Rosenbaum
St. Louis Public Radio
U.S. Rep. Jason Smith, R-Salem, listens to attendees at a roundtable of health care professionals on Monday at Crystal City City Hall in Jefferson County. Smith is chairman of the U.S. House Ways and Means Committee.

Members of Congress are entering a high-stakes legislative battle over funding the federal government, which some have said could be a tipping point that threatens House Speaker Kevin McCarthy's job.

But one key Missouri Republican lawmaker says that fears McCarthy could be ousted are overblown, adding that people have consistently underestimated the California Republican’s ability to balance his caucus’ idiosyncratic nature.

“There is a funding fight. There's no question about that,” Smith said. “But Speaker McCarthy is the best leader at the right time.”

Politico reported Monday that McCarthy is facing pressure from his caucus’ more conservative elements to demand spending cuts in legislation that will keep the federal government open. That comes at a time when he’s trying to balance Republican lawmakers who want to impeach President Joe Biden and those who feel such an endeavor would be a waste of time.

Smith, the chairman of the powerful Ways and Means Committee, said that McCarthy has proven himself able to deal with difficult legislative battles. That includes a recent episode in which he was able to get a debt ceiling package through Congress that included some concessions from the Democratic Senate and Biden.

“A lot of the media outlets in D.C. like to underestimate Speaker McCarthy. They have said all along that he wasn't going to become speaker. He did become speaker after 15 rounds,” Smith said. “They said that we wouldn't pass a debt limit increase. And he did the Fiscal Responsibility Act, which actually will lead to spending this coming year being less than spending the year before.”

Republicans have a narrow majority in the House, which means they would need Democratic votes to pass a federal spending plan in the coming weeks. That’s what happened with the debt ceiling bill, which passed 314 to 117.

Rural health care concerns

Smith was in Crystal City on Monday to hear from mainly rural health care professionals who were concerned about being able to stay in business. As chairman of Ways and Means, Smith has a major say over how programs like Medicaid and Medicare operate.

Several attendees pointed out that reimbursement rates, especially from programs like Medicare, pay providers uneven rates depending on geography. Smith pointed to an example where a medical provider getting a heart monitoring reimbursement in an urban area would receive $70 — but a similar treatment would only bring a $40 reimbursement in southeast Missouri.

“Move that up to $55 and bring them down to $55,” Smith said. “So changing those disparities is one big way in making sure that we're all treated equally.”

Smith noted that in the past 10 years, five rural hospitals in his largely rural 8th Congressional District have closed. And he said reimbursement rates play a major role in whether these facilities can remain viable.

“The disparity in the reimbursement rates lead to less health care services throughout Missouri," he said.

Jason is the politics correspondent for St. Louis Public Radio.