Early in June, the Missouri legislature passed a bill that would allow employers to refuse insurance coverage for abortions, sterilizations, and even coverage of contraception. Since the passage of the bill, the legislation has sat on Democratic Governor Jay Nixon’s desk, waiting for a signature or a veto.
Alison Gee, Vice President of Public Policy, Planned Parenthood of the St Louis Region, expressed concern that the legislation is “an attempt to undermine” the no co-pay rule established under the Affordable Care Act, which would allow women access to these services through their private health insurance at no additional cost. By vetoing the legislation, Nixon would make it clear that he stands with women and their families when it comes to making choices about their own health care needs.
“A veto from Governor Nixon would send a huge message to women and families in this state that he stands with them for fairness, equality, and good preventive health care,” said Alison Gee, Vice President of Public Policy, Planned Parenthood of the St Louis Region.
“After all, why should women in Missouri receive less coverage than women in every other state?”
Governor Nixon is expected to announce at an 11 a.m. central press conference whether or not he will veto the legislation.
UPDATED: Nixon has vetoed the bill, saying the legislation would “impose its will, and deny inclusion of contraceptive coverage, even if that position is inconsistent with the rights and beliefs of the employee or employer.”
So far this year, legislators have introduced 1,256 provisions relating to sexual and reproductive health and rights. However, states have also enacted 22 measures this year designed to expand access to reproductive health services or protect reproductive rights.
So far this year, legislators have introduced 1,256 provisions relating to sexual and reproductive health and rights. Of these, 35 percent (445 provisions) sought to restrict access to abortion services. By midyear, 17 states had passed 46 new abortion restrictions.
Including these new restrictions, states have adopted 334 abortion restrictions since 2010, constituting 30 percent of all abortion restrictions enacted by states since the U.S. Supreme Court decision in Roe v. Wade in 1973. However, states have also enacted 22 measures this year designed to expand access to reproductive health services or protect reproductive rights.
Signs of Progress
The first half of the year ended on a high note, with the U.S. Supreme Court handing down the most significant abortion decision in a generation. The Court’s ruling in Whole Woman’s Health v. Hellerstedtstruck down abortion restrictions in Texas requiring abortion facilities in the state to convert to the equivalent of ambulatory surgical centers and mandating that abortion providers have admitting privileges at a local hospital; these two restrictions had greatly diminished access to services throughout the state (see Lessons from Texas: Widespread Consequences of Assaults on Abortion Access). Five other states (Michigan, Missouri, Pennsylvania, Tennessee, and Virginia) have similar facility requirements, and the Texas decision makes it less likely that these laws would be able to withstand judicial scrutiny (see Targeted Regulation of Abortion Providers). Nineteen other states have abortion facility requirements that are less onerous than the ones in Texas; the fate of these laws in the wake of the Court’s decision remains unclear.
Ten states in addition to Texas had adopted hospital admitting privileges requirements. The day after handing down the Texas decision, the Court declined to review lower court decisions that have kept such requirements in Mississippi and Wisconsin from going into effect, and Alabama Gov. Robert Bentley (R) announced that he would not enforce the state’s law. As a result of separate litigation, enforcement of admitting privileges requirements in Kansas, Louisiana, and Oklahoma is currently blocked. That leaves admitting privileges in effect in Missouri, North Dakota, Tennessee and Utah; as with facility requirements, the Texas decision will clearly make it harder for these laws to survive if challenged.
More broadly, the Court’s decision clarified the legal standard for evaluating abortion restrictions. In its 1992 decision in Planned Parenthood of Southeastern Pennsylvania v. Casey, the Court had said that abortion restrictions could not impose an undue burden on a woman seeking to terminate her pregnancy. In Whole Woman’s Health, the Court stressed the importance of using evidence to evaluate the extent to which an abortion restriction imposes a burden on women, and made clear that a restriction’s burdens cannot outweigh its benefits, an analysis that will give the Texas decision a reach well beyond the specific restrictions at issue in the case.
As important as the Whole Woman’s Health decision is and will be going forward, it is far from the only good news so far this year. Legislators in 19 states introduced a bevy of measures aimed at expanding insurance coverage for contraceptive services. In 13 of these states, the proposed measures seek to bolster the existing federal contraceptive coverage requirement by, for example, requiring coverage of all U.S. Food and Drug Administration approved methods and banning the use of techniques such as medical management and prior authorization, through which insurers may limit coverage. But some proposals go further and plow new ground by mandating coverage of sterilization (generally for both men and women), allowing a woman to obtain an extended supply of her contraceptive method (generally up to 12 months), and/or requiring that insurance cover over-the-counter contraceptive methods. By July 1, both Maryland and Vermont had enacted comprehensive measures, and similar legislation was pending before Illinois Gov. Bruce Rauner (R). And, in early July, Hawaii Gov. David Ige (D) signed a measure into law allowing women to obtain a year’s supply of their contraceptive method.
But the Assault Continues
Even as these positive developments unfolded, the long-standing assault on sexual and reproductive health and rights continued apace. Much of this attention focused on the release a year ago of a string of deceptively edited videos designed to discredit Planned Parenthood. The campaign these videos spawned initially focused on defunding Planned Parenthood and has grown into an effort to defund family planning providers more broadly, especially those who have any connection to abortion services. Since last July, 24 states have moved to restrict eligibility for funding in several ways:
Seventeen states have moved to limit family planning providers’ eligibility for reimbursement under Medicaid, the program that accounts for about three-fourths of all public dollars spent on family planning. In some cases, states have tried to exclude Planned Parenthood entirely from such funding. These attacks have come via both administrative and legislative means. For instance, the Florida legislature included a defunding provision in an omnibus abortion bill passed in March. As the controversy grew, the Centers for Medicare and Medicaid Services, the federal agency that administers Medicaid, sent a letter to state officials reiterating that federal law prohibits them from discriminating against family planning providers because they either offer abortion services or are affiliated with an abortion provider (see CMS Provides New Clarity For Family Planning Under Medicaid). Most of these state attempts have been blocked through legal challenges. However, a funding ban went into effect in Mississippi on July 1, and similar measures are awaiting implementation in three other states.
Fourteen states have moved to restrict family planning funds controlled by the state, with laws enacted in four states. The law in Kansas limits funding to publicly run programs, while the law in Louisiana bars funding to providers who are associated with abortion services. A law enacted in Wisconsin directs the state to apply for federal Title X funding and specifies that if this funding is obtained, it may not be distributed to family planning providers affiliated with abortion services. (In 2015, New Hampshire moved to deny Title X funds to Planned Parenthood affiliates; the state reversed the decision in 2016.) Finally, the budget adopted in Michigan reenacts a provision that bars the allocation of family planning funds to organizations associated with abortion. Notably, however, Virginia Gov. Terry McAuliffe (D) vetoed a similar measure.
Ten states have attempted to bar family planning providers’ eligibility for related funding, including monies for sexually transmitted infection testing and treatment, prevention of interpersonal violence, and prevention of breast and cervical cancer. In three of these states, the bans are the result of legislative action; in Utah, the ban resulted from action by the governor. Such a ban is in effect in North Carolina; the Louisiana measure is set to go into effect in August. Implementation of bans in Ohio and Utah has been blocked as a result of legal action.
The first half of 2016 was also noteworthy for a raft of attempts to ban some or all abortions. These measures fell into four distinct categories:
South Carolina and North Dakota both enacted measures banning abortion at or beyond 20 weeks post-fertilization, which is equivalent to 22 weeks after the woman’s last menstrual period. This brings to 16 the number of states with these laws in effect (see State Policies on Later Abortions).
Indiana and Louisiana adopted provisions banning abortions under specific circumstances. The Louisiana law banned abortions at or after 20 weeks post-fertilization in cases of diagnosed genetic anomaly; the law is slated to go into effect on August 1. Indiana adopted a groundbreaking measure to ban abortion for purposes of race or sex selection, in cases of a genetic anomaly, or because of the fetus’ “color, national origin, or ancestry”; enforcement of the measure is blocked pending the outcome of a legal challenge.
In addition, 14 states (Alaska, Arizona, Florida, Georgia, Idaho, Indiana, Iowa, Kentucky, Louisiana, Maryland, South Carolina, South Dakota, Tennessee and Utah) enacted other types of abortion restrictions during the first half of the year, including measures to impose or extend waiting periods, restrict access to medication abortion, and establish regulations on abortion clinics.
Zohra Ansari-Thomas, Olivia Cappello, and Lizamarie Mohammed all contributed to this analysis.
Missouri legislators protect and fund crisis pregnancy centers, while ignoring how their constituents are affected by violence and health-care disparities. A new campaign is taking to the streets to refocus their attention.
When I found out in 2015 that anti-choice politicians in Missouri had formed the Senate Interim Committee on the Sanctity of Life, I was outraged that they planned to use valuable time and money to bully Planned Parenthood with yet another baseless investigation.
My second thought was that I wished someone would form a committee to investigate the real issues that threaten the lives of Missourians every day.
Erin Matson and I co-founded Reproaction because we believe in the power of direct action; that the current state of abortion access is a manmade humanitarian crisis; and that people must have the right to decide whether to parent and to live in communities free of violence and oppression.
Those core values inspired us to launch the Show-Me Accountability Campaign in Missouri on June 29. Through the campaign we are leading direct actions to hold members of the Senate Interim Committee on the Sanctity of Life accountable, and demanding Missouri politicians work on the real challenges our communities and neighbors face, such as gun violence and Black infant mortality.
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Missourians deserve access to health care and safe communities, but that’s not the focus of anti-choice legislators. Instead, our lawmakers choose to persecute abortion providers and dish out tax credits to sham crisis pregnancy centers (CPCs).
Missourians have had enough. That’s what brought local progressive activists together, led by Reproaction Missouri organizer Zoe Krause, to launch Show-Me Accountability. We gathered on the sidewalk in front of Thrive, one of at least 65 CPCs anti-choice lawmakers champion despite the fact that the centers have a history of lying to patients seeking reproductive health care. Missouri lawmakers have even pushed legislation to guarantee CPCs aren’t subject to regulation or oversight. We chose Thrive as the location of our launch to illustrate the contrast between what Missouri politicians fund, prioritize, and protect, versus what Missourians actually need them to focus on.
Someone turned the sprinklers on at Thrive just as activists started showing up, providing a nonstop shower that drenched people walking or standing on much of the sidewalk in front of the building. It was an old-school disruption move that made it clear they knew we were coming and weren’t happy about it. We shifted down the sidewalk and started to get in formation.
Several interns from Thrive came outside and tried to physically disrupt our work by repeatedly moving between activists and attempting to surround us. But when we engaged them in conversation, they didn’t appear to know much about the services Thrive provides or that CPCs get tax credits in Missouri. As our speakers began their remarks, Thrive counselors in bright orange vests held signs and guarded the walkway up to the building. I’m familiar with the vests and signs because they are usually seen stationed in front of Missouri’s only abortion provider a few blocks away.
The speakers were amazing, their topics a damning indictment of the issues that wither on the vine in Jefferson City while politicians compete for the attention of anti-abortion lobbyists. Kirstin Palovick, organizer for the grassroots LGBT equality organization PROMO, explained why it hurts our state that lesbian, gay, bisexual, and transgender people in Missouri can be fired from their jobs, evicted from their homes, and denied access to public accommodations and services. Cicely Paine, fellowship manager at CoreAlign and board chair for Community Birth and Wellness, shared her experience as a sex educator in Missouri, where access to comprehensive sex education is not a right enjoyed by all. Mustafa Abdullah, lead organizer for the American Civil Liberties Union of Missouri, passionately detailed the real-world consequences of racial disparities in policing and why police violence is a reproductive justice issue.
I was the final speaker and used my time to talk about why the Black infant mortality rate is a public health crisis worthy of attention and urgency. We ended with chants and a few dances through the shower provided by Thrive’s sprinkler system.
The timing for our campaign launch couldn’t have been better. Shortly after the action at Thrive, the chair of the Senate Interim Committee on the Sanctity of Life announced that there would be a press conference in Jefferson City to discuss a report detailing the results of their “work.” So, Zoe and I took a road trip to the Missouri capitol to witness firsthand what the committee had to say and ask some questions.
At around 1 p.m., several anti-choice members of the committee, including chair Sen. Kurt Schaefer (R-Columbia), gathered in the fourth floor mezzanine in the capitol. Neither Sen. Jill Schupp (D-Creve Coeur) nor Sen. Maria Chappelle Nadal (D-St. Louis), the only pro-choice members of the committee, were in attendance. Neither contributed to the report.
As expected, the yearlong investigation found no evidence that tissue has been illegally sold. Sen. Schaefer acknowledged that the report was not an official report of the committee. Instead, the senators used the press conference to fuss about the U.S. Supreme Court’s recent Whole Woman’s Health v. Hellerstedt decision and voice their frustration over not having uncovered much of anything.
“What is clear is there are many things that are unclear,” Sen. Eric Schmitt (R-Glendale) said during the press conference.
On that one point, I agree.
It remains unclear how much this investigation cost Missourians. We deserve a proper accounting for just how much we invested in this farce. But when Reproaction’s Zoe Krause asked that question during the press conference, the senators refused to answer.
What is clear is that the committee’s press conference was partisan because the committee formed as a platform for anti-choice propaganda. It is clear that the anti-abortion videos used as the excuse for forming the committee have been thoroughly debunked.
Sadly, it is more than clear that some members of the committee think they can get away with wasting the people’s time trying to score political points with anti-choice groups.
We drove away from the capitol more committed than ever to the Show-Me Accountability Campaign. Missourians deserve legislators who will prioritize real-world issues, and we will demand accountability from those who fail to do so. Media coverage of our launch has already sparked long-overdue discussions about the damaging consequences of our state legislature’s misplaced priorities.
That’s the kind of fertile soil accountability can grow in, and we intend to see it grow in Missouri. We are in this for dignity, justice, and liberation. And we’re just getting started.