Truman Medical Centers in Kansas City will stop contributing to a financial pooling arrangement that helps maintain political support for a tax that pumps hundreds of millions of dollars into Missouri’s Medicaid program every year. 

Truman Medical Centers' campus at 23rd and Holmes in Kansas City.

The move, which lawmakers began learning about last week, has raised concerns that other providers could follow Truman’s lead — and could ultimately doom the provider tax and the funding it has provided the state for nearly three decades. 

The provider taxes were first enacted in 1992, but a bitter political fight over contraceptive coverage and Planned Parenthood pushed an extension of the taxes into a special legislative session in late June. House Budget Committee Chairman Cody Smith, R-Carthage, who guided the bill through the House, said the pooling arrangement has helped maintain support for the taxes from hospitals that do not serve a large number of Medicaid clients.