Missouri lawmakers look to ban time limits on anesthesia coverage

JEFFERSON CITY — Missouri health insurance providers would be barred from limiting coverage of anesthesia under legislation being considered by Gov. Mike Kehoe.

As part of a wide-ranging health care bill approved last month, lawmakers included a provision made in response to a proposed policy change floated by Anthem Blue Cross Blue Shield in 2024.

The insurer, which provides health coverage to an estimated 2 million Missourians, initially said it no longer would pay for anesthesia care if a surgical procedure went beyond a specific time limit.

The company dropped the plan after it triggered widespread outrage, with critics suggesting patients could wake up in the middle of a surgical procedure because of the time limits.

Despite the company’s decision to scuttle the proposal, Missouri lawmakers said they wanted to make sure others could not impose time limits on anesthesia.

Under the legislation, “no health carrier or health benefit plan shall establish, implement, or enforce any policy, practice, or procedure that imposes a time limit for the payment of anesthesia services provided during a medical or surgical procedure.”

The provision is included in House Bill 2372, which was sponsored by Rep. Tara Peters, R-Rolla, and approved on the second-to-last day of the legislative session. Kehoe is reviewing the legislation, but is not expected to sign off on any bills this week. He has until mid-July to act.

Rep. David Tyson Smith, D-Columbia, praised the addition of the anesthesia language after falling short last year in his bid to get stand-alone legislation through the General Assembly.

“That caused a national uproar. They finally backed off. It was really egg on their face for even suggesting it,” Smith told colleagues in the House during final debate. “It’s time to send a message to insurance companies that people come first.”

In addition to Smith’s concerns, House Speaker Jon Patterson, a Lee’s Summit physician, pressed for the adoption of the measure, saying imposing artificial time limits on medical procedures could be harmful to patients.

The now-scrapped billing scheme would not have applied to patients under the age of 22 or maternity-related care, according to Anthem.

The company said it would drop the plan last year citing “widespread misinformation” about how the change would work.

Anthem said Smith’s original legislation would not have had any effect on the proposed change because “it never was and never will be the policy of Anthem Blue Cross Blue Shield to not pay for medically necessary anesthesia services.”

In a statement Thursday, Anthem spokesman Jim Turner said the insurer supports the overall legislation, which includes multiple changes in state law regarding health care, ranging from provisions designed to address Missouri’s high maternal mortality rate to improved reporting of alpha gal syndrome, a tick-borne disease that can cause an allergy to red meat.

“It will help improve access to care, supporting patients and healthcare providers – strengthening Missouri’s healthcare system,” Turner said in an email.

The company’s hasty retreat came amid intense scrutiny of the health insurance industry after the shooting death of UnitedHealthcare CEO Brian Thompson in New York City in December 2024.

Thompson, 50, was killed as he walked in Manhattan to UnitedHealth Group’s annual investor conference. Surveillance video showed a masked gunman shooting him from behind.

The suspect, Luigi Mangione, faces a September murder trial in New York.

The Missouri Society of Anesthesiologists also strongly opposed the change floated by Anthem, saying it posed a significant threat to the safety of Missouri patients and undermined the critical role anesthesiologists play in surgical care.

© 2026 the St. Louis Post-Dispatch. Visit www.stltoday.com. Distributed by Tribune Content Agency, LLC.