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Missouri bill aimed at kicking Planned Parenthood off of Medicaid heads to governor's desk

The House passed the bill Wednesday. It got Senate approval earlier this month.

JEFFERSON CITY, Mo. — A Missouri bill aimed at barring Medicaid funding from going to abortion health care providers like Planned Parenthood has been sent to Missouri Gov. Mike Parson’s desk.

State Rep. Cody Smith (R-Jasper County) said Missouri House Bill 2634 would prohibit taxpayer dollars, primarily in the Medicaid program, from going toward organizations that perform abortions and their affiliates, like Planned Parenthood, which is a national organization.

“We know that if we were subsidizing or doing business with Planned Parenthood as a state, we potentially could ultimately be subsidizing those abortion services outside of the state,” Smith said.

Smith said this is something the largely conservative legislature has been trying to address for years.

“I believe it was 2017, we added language into the House budget or to the Missouri state budget in the appropriations bills to try to prohibit this funding from going towards abortion providers and to their affiliates. And that ended in a Supreme Court decision known as the Planned Parenthood Decision that basically said that we couldn't do that through the appropriations process. And we tried a second way to do that through the appropriations process, kind of a different approach, and ultimately, that resulted in the second Supreme Court decision which said we couldn't do it in the second way that we attempted to do it,” Smith said.

He said he is confident this approach will stand up in court.

State Rep. Brad Hudson (R-Stone and Christian counties), who co-sponsored the legislation, said they were already expecting it would be challenged again.

“We have an executive branch that is willing to aggressively defend legislation that is passed by the General Assembly. We understand that anytime we do something big like this, there's the possibility for a court challenge. And that has been taken into consideration when the legislation was crafted,” Hudson said.

Hudson said as a pastor, he believes this legislation is the right thing to do.

“I believe that our rights do not come from government, they come from God. And it is the government's responsibility to acknowledge and protect those God-given rights, the first of which is the right to life,” Hudson said.

Abortion was largely banned in Missouri over a year ago.

State Rep. Deb Lavender, (D-St. Louis County) voted against the legislation saying this is not about abortion anymore.

“It's for political gains. There's no point in defunding Planned Parenthood at this point. And it's just shameful that the way we're attempting to prove we're pro-life is to take health care from women in our state,” Lavender said.

Lavender said there’s really no point to this legislation as a federal measure called the Hyde Amendment already bans the use of federal Medicaid funds to cover abortion. However, it doesn’t limit the state’s ability to use its funds to cover abortions.

“For the women who go there, we're just taking healthcare away from them. So once again, women will be on the short end of health care in Missouri. We don't already do a good job for our people of color, their maternal mortality is so much higher than those of us who are white. And so we're just further eroding health care opportunities for women in this state,” Lavender said.

She said this effectively would take healthcare away from more than 30,000 people in our state.

“Women, men and the transgender community can all receive healthcare at Planned Parenthood without judgment. Those are the people we’re going to be turning away from access to healthcare,” Lavender said.

Representatives for Planned Parenthood said this measure also violates federal Medicaid law which guarantees every patient’s freedom to choose any willing and qualified provider.

Smith said they believe the market will provide other solutions.

“We've seen over the recent years, many different types of primary care providers come online. We've got the Federally Qualified Healthcare Centers across the state, they're commonly known as FQHCs, that provide primary care and a whole variety of services, including sexual health services. We have many alternatives to abortion providers that are coming up across the state that are also Medicaid providers that can provide those types of services. And we've seen large hospital systems really make investments in their primary care services in an effort to kind of divert folks away from their emergency departments,” Smith said.

Hudson said it was never the intent to take away services.

“There's certainly no intention on the part of mine or the part of any of the other co-sponsors trying to keep folks from getting the care that they need. But at the same time, we've got to make sure that taxpayer dollars don't go to facilities that perform abortions. So what we've got to do is everything possible to make sure that there are places out there where folks can get the care that they need, but also those places don't put in danger, innocent unborn lives,” Hudson said.

Lavender said health care in the state is already stretched thin.

“Our Federally Qualified Healthcare Centers are full. Waiting lists are two to 10 weeks. Like so many of our clinics right now, half of them are understaffed. We don't have room to move 30,000 women for healthcare into a different location,” Lavender said.

Maggie Olivia with Abortion Action Missouri said many people will lose what little options they have right now.

“The majority of births that take place in our state, are covered by Medicaid. And we know that that's happening while the majority of Missourians live in counties that are classified as maternal healthcare deserts. And so long story short, the safety net itself is already so strained that it's frankly not sustainable as it is, and we're not meeting people's needs, at the level where they are. This bill will further strain that safety net and hundreds of thousands of Missourians will lose access to their provider,” Olivia said.

So what does this mean for a ballot measure seeking to end the ban on abortions? 

Olivia said the proposed amendment if approved by voters, would only guarantee access to abortion and reproductive health care.

“There is no language on this amendment about Medicaid or payments or anything like that. So they are totally separate issues,” Olivia said.

She said she does have hope and is inspired by the conversations that are coming up more frequently now.

“Missourians are having more and more conversations about sexual and reproductive health care than ever before. And I think that the politicians behind these attacks on Missourians, who rely on Medicaid, will face consequences in November,” Olivia said.

She said this measure is not an attack on Planned Parenthood.

“This is an attack on the people of Missouri and the services that they rely on to survive, whether that be preventative care, like cancer screenings, STI testing and treatment and birth control access which can treat a myriad of health issues,” Olivia said.

Planned Parenthood Great Plains and Planned Parenthood St. Louis Region and Southwest Missouri released this joint statement Wednesday: “Yet again, members of the state legislature have decided to attack the lifesaving health care Missourians rely on rather than address the health care needs of the people they represent. Despite the courts repeatedly ruling that ‘defunding’ Planned Parenthood health centers is unconstitutional, lawmakers continue to deny critical care like birth control, cancer screenings, wellness exams, and STI testing & treatment from the patients who need it. Experts are clear: there are not enough other providers in the healthcare safety-net system to absorb Planned Parenthood’s patients. At Planned Parenthood, we’ll continue to do everything we can to continue serving our patients — no matter what.”

Hudson and Smith expect the governor will sign the bill.

If signed into law and not struck down in the courts, the funding ban would go into effect in late August.

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