Missouri is at risk of losing $4.5 billion in tax revenue and federal funding for Medicaid health insurance.

At issue is an effort by some Republican lawmakers to stop Medicaid coverage for some contraceptives. They want to attach the ban to a tax that provides a significant chunk of Medicaid funding.

Missouri hospitals, doctors and other health care providers are taxed. Then the money is used to draw down federal Medicaid funding.

The state expects to bring in about $1.6 billion in taxes in the 2022 fiscal year, which would draw down another $2.9 billion in federal funding. But lawmakers didn't reauthorize the tax this year. It expires Sept. 30.

Federal law requires Medicaid programs cover family planning.