‘Got to play the game’: Missouri doctors group jumps into state politics with $1.5M PAC investment

The association, which represents doctors and doctors in training, already has a committee, MO Medical PAC, for pass-through contributions from members. But until this year, the association had used its own funds to contribute only $19,625 to political committees since 2001, Missouri Ethics Commission records show, and has made no donations since 2014.

The money will be contributed to candidates in this year’s legislative elections, said Jeff Howell, executive vice president of the association. The association supports legislation to put limits on prior authorization for medical services and ending the use of managed care for the state’s Medicaid recipients.

“We’re interested in ensuring that Missourians have access to the highest quality healthcare and to reinvest in that through those two PACs,” Howell said.

The donations immediately put the two PACs among the ranks of the best-funded political action committees representing lobbying interests. Only two donors, Michael Rayner, part of the family that owns the agribusiness firm Cargill, and retired investor Rex Sinquefield have contributed more to non-ballot issue committees.

And only four PACs have contributed or spent more than $1.5 million to influence this year’s elections.

The donations got the attention of other big contributors, who wonder how the money will be used.

“Anytime anybody drops that kind of money into a couple PACs, the light bulb kind of goes off, and you’re kind of trying to figure it out,” said Andy Arnold, a long-time lobbyist who donates client funds to candidates from an entity called Paladin PAC.

Paladin PAC has contributed $579,700 to candidate committees and other PACs since the start of 2025 as Arnold pursues legalization of video lottery terminals. All of the money came from J&J Ventures, an Illinois game vendor.  

The medical association already drew notice in the political world when it gave $100,000 to the PAC supporting Dr. Ellen Nichols in her unsuccessful campaign against incumbent state Sen. Jill Carter in the 32nd District Republican primary.

The donation was unusual for the association, Arnold said, but didn’t necessarily signal a change in legislative races statewide.

“She’s a physician. She was running against somebody that wasn’t a physician, and they apparently had some beef with Sen. Carter,” Arnold said. “I don’t know what the beef was, but apparently they did because you don’t just drop $100,000 into a campaign against an incumbent just to do it.”

In this year’s legislative session, the association supported Republican state Rep. Melanie Stinnett’s bill limiting the use of prior authorization for common medical treatments and making other changes intended to make prior authorizations more transparent.

The bill passed the House and stalled in the state Senate. Stinnett is a candidate for state Senate in the 30th District.

The association wants to end or limit the use of managed care in Medicaid, Howell said.

Missouri has paid private insurers to manage parts of the program since the 1990s and expanded their role in 2015 to cover all recipients except people with disabilities and those 65 and over.

“We’d prefer to have it be fee-for-service the way it used to be,” Howell said. “There’s a reason they passed that in the middle of the night.”

A September report by Physicians for a National Health Program, which advocates for a single-payer system, estimated Missouri could save up to $259 million a year in general revenue if the state managed Medicaid directly. Managed care companies refute those findings, arguing their services are necessary to ensure there are financial incentives for care that makes enrollees healthier.

Ed Weisbart, Missouri chair of Physicians for a National Health Program, said the decision to use association funds for politics is long overdue.

“I’ve always thought they were not doing enough,” Weisbart said. “The challenge has been finding the common ground that I thought they should work on that they wanted to work on.”

In 2013, Democratic Gov. Jay Nixon wanted the Republican-controlled General Assembly to expand eligibility for Medicaid under the Affordable Care Act provisions that capped Missouri’s share of the program at 10% of the cost.

The effort failed, and Missouri did not expand eligibility until a 2020 ballot measure mandating coverage. 

Weisbart was on the association’s legislative committee.

“The committee voted to support that initiative, but leadership above the committee didn’t seem particularly interested in prioritizing that as something that they were going to really fight for,” Weisbart said.

The association’s MO Medical PAC, used to accumulate modest donations from physicians, has raised $113,364 since the start of 2025 and made $123,275 in contributions.

The Missouri Health Plan Association PAC, which backs keeping Medicaid recipients in managed care programs, has raised $180,000 and contributed $204,700.

The decision to create the two new PACs is part of being a lobbying interest in Jefferson City, Howell said.

“If other people are going to play the game, you’ve got to play the game,” he said.

The medical association was founded in 1850 and predates the Missouri Chamber of Commerce and Industry by more than 70 years. 

“People have acted a little bit surprised by this,” Howell said. “They really shouldn’t be. We’ve been around forever.”

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