Missouri's supplemental budget bill signed into law Thursday includes a provision to block patients who rely on Medicaid from accessing Planned Parenthood health centers.
Federal Medicaid law protects patients' rights to choose their providers, including Planned Parenthood.
Michelle Trupiano, executive director of the Missouri Family Health Council, noted because of the Hyde Amendment, Medicaid cannot cover abortions, but Planned Parenthood provides a wide array of family planning and reproductive care, from birth control and STI testing and treatment to cancer screenings and other preventive services.
"The safety net is already at capacity and stretched very thin, it can take weeks for patients to get an appointment, and we need all the providers working together to meet the needs," Trupiano observed. "All this ideological attack does is further the disparities that already exist in Missouri."
Trupiano pointed out family planning and reproductive-health providers saw more than 40,000 patients in Missouri in 2021, and more than half were at Planned Parenthood.
Last year, the Missouri Supreme Court struck down a similar attempt to defund Planned Parenthood in the budget bill, and advocates say litigation will be filed again this time.
Trupiano stressed there are many steps the Legislature could take to improve access to reproductive-health care. She urged them to support and promote Medicaid expansion, so everyone has access to the full range of services they need, including family planning.
However, she added lawmakers have been working to undermine expansion, even though it was passed by voters as a constitutional amendment in 2020.
"And then more specific to ways to improve reproductive and sexual health," Trupiano outlined. "We would love to see the expansion of postpartum coverage for folks who have recently given birth that they don't get kicked off of Medicaid 60 days after they have given birth."
The supplemental budget bill, much of it using federal money, funds Medicaid for the rest of the fiscal year, which ends in June, and includes $1.9 billion for local public school districts, nearly $100 million for nonpublic schools, more than $400 million for child care and more than $200 million for school food programs.
Support for this reporting was provided by The Carnegie Corporation of New York.
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Missouri residents are worried about future access to birth control.
The latest survey from The Right Time, an initiative based in Missouri, focused on efforts to improve access to contraception across the state. These concerns are shared across political affiliations. Despite strong support for young adults ages 18 to 35 having access to all forms of birth control, one in every three Missourians feels policymakers are not supportive of that aim.
Michelle Trupiano, executive director of the Missouri Family Health Council, said that's one reason behind the effort to amend the state's Constitution.
"Missourians concerned with the ability to get birth control in the future will have an opportunity to enshrine reproductive freedom, including birth control, into the state Constitution if enough signatures are gathered to put this issue on the ballot," she said.
In the survey, 78% of the 1,000 respondents said they think emergency rooms in Missouri should make contraception available to survivors of domestic and sexual violence or human trafficking. This includes 82% who identify as Republicans, 87% of Democrats and 72% of Independents.
House Joint Resolution 72 has been introduced by Republicans to change the way amendments can be made to Missouri's Constitution. It would require not only a majority of votes statewide, but also a majority in each of the state's eight congressional districts - making it much tougher for any amendment to pass.
Rep. Bridget Walsh Moore, D-South St. Louis County, said she hopes voters understand the importance of the initiative petition process.
"Why this is coming to a head so much this year is because they know abortion will pass," she said, "and they're just upset that they can't override the will of the people. This is a way for the people to circumvent the government."
Trupiano emphasized that attempts at changing the petition process would make things difficult for a majority of Missourians - and not only in terms of access to contraception.
"The voters have spoken loud and clear about the priorities that they want focused on in the state, including Medicaid expansion, including extending minimum wage," she said, "and the Legislature is trying to take away the voters' ability."
The current petition to add abortion rights to the Missouri Constitution needs 171,000 signatures from at least six congressional districts by May 5.
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The Alabama House and Senate both passed bills this week that would help people resume in vitro fertilization and provide legal protections for providers and patients in certain cases.
Senate Bill 159 and its companion House Bill 237 passed swiftly despite debates surrounding immunity and personhood.
While this is a positive step that allows families to resume treatments, said Heidi Miller, development manager for the reproductive-justice group Yellowhammer Fund, they're still concerned with the limited timeframe offered by the bills, including the one sponsored by Sen. Tim Melson, R-Florence.
"So, it just feels like a very limited solution to me, and that's our stance as an org, is that it feels like very much like a Band-Aid on open wounds," she said. "And so, that's how we've kind of been looking at those bills, because Sen. Melson's bill similarly would be repealed on April 1, 2025."
Both bills would apply retroactively and be automatically repealed next year, which Miller said could affect families again. This comes after IVF programs around the state stopped offering the service over concerns about legal consequences following a 8-1 state Supreme Court ruling. The court ruled that frozen embryos are protected by the state's Wrongful Death of a Minor Act that protects children, regardless of location.
Acknowledging the temporary nature of the bills, Miller argued that a short-term solution is insufficient for people seeking IVF treatments, which sometimes can take months or years. She said they're urging lawmakers to take further action to safeguard the accessibility of IVF.
"For us to get the constitutional amendment - the, quote, 'sanctity of life' constitutional amendment from 2018 - back for a re-vote in front of Alabama voters," she said, "because that would be the long-term solution that would really protect IVF access."
Unless the constitutional amendment is repealed, she said, it could supersede any other law or code, specifically where the term 'child' or 'minor child' is not defined. Miller said the Yellowhammer Fund has resources on its website for people who want to know more.
House Minority Leader Anthony Daniels, D-Huntsville, is sponsoring two measures, including a constitutional amendment, to clarify that an extrauterine embryo should not be considered an "unborn life" or "unborn child."
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Legislation in Massachusetts would ban some of the tactics used by "crisis pregnancy centers" to prevent people from having abortions.
Many of the centers have the words "medical" or "health" in their names, but do not offer licensed reproductive medical care.
Laurie Veninger, reproductive rights activist for the Indivisible Massachusetts Coalition, said the centers advertise "free" tests and ultrasounds and then pressure women into continuing their pregnancies.
"If they were a business, that would be curtailed by existing laws about deceptive advertising," Veninger pointed out. "But these places are religious nonprofits."
Veninger explained the crisis centers are often located near abortion providers, where anti-abortion activists try to lure people their way. Abortion opponents contend the centers simply offer confidential services to those facing unplanned pregnancies.
Following complaints, the Department of Public Health recently sent a memo to nearly 30 crisis pregnancy centers regarding state laws and patients' rights.
Veninger argued Massachusetts is "in the crosshairs" of what she calls "religious extremists," targeting states where abortion remains legal. She asserted many low-income people are being deceived, with potentially dangerous outcomes.
"Some of them have told us that they called up and made an appointment, because they thought they were going there for an abortion," Veninger observed. "And then when they got there, didn't get one, and then, they had to wait another week to get the appointment at the real clinic."
Veninger emphasized the extra week can mean the difference between having a medication abortion or requiring a surgical procedure. A class-action lawsuit claims a nurse at the Clearway Clinic in Worcester County failed to inform a patient her ultrasound showed an ectopic pregnancy, nearly costing the patient her life.
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