Analysis Law and Policy

Missouri Republicans Introduce Dozens of Anti-Choice Bills While Rejecting Medicaid Expansion

Teddy Wilson

No state has seen as many anti-choice bills introduced this year as Missouri, where Republican lawmakers are simultaneously resisting an expansion of Medicaid that could improve health outcomes for hundreds of thousands of residents.

In Republican-controlled state legislatures across the country, more than 100 anti-choice bills have been introduced this year. But no state has seen as many of these bills as Missouri, where Republican lawmakers are simultaneously resisting an expansion of Medicaid expansion that could improve health outcomes for hundreds of thousands of residents.

Republican lawmakers in the state have introduced at least 32 bills this year that would restrict access to reproductive health care, often justifying the regulations as protecting women’s health. The bills appear to be part of a coordinated strategy between GOP legislators and anti-choice organizations. “We’re looking to pass at least a couple [bills], if not more,” Susan Klein, the top lobbyist for Missouri Right to Life, told the Washington Post earlier this month. According to Klein, the lawmakers’ plan is to introduce individual bills with specific regulations, as opposed to omnibus bills, like the one passed last summer in Texas.

Angie Postal, director of public policy at Planned Parenthood of the St. Louis Region and Southwest Missouri, told Rewire that the amount of anti-choice legislation in the state is troubling. “What’s concerning is that they have already done so much this session, and the session is only really now half over,” she said. “They’ve spent so much time already debating abortion on the floor of both chambers that it’s hard to say which ones are going to pass, because there are so many options for [the lawmakers].”

The anti-choice legislation that’s progressed the furthest this session would require women to wait 72 hours before receiving an abortion, up from the 24 hours they are already required to wait. HB 1307 and HB 1313, sponsored by Reps. Kevin Elmer (R-Nixa) and Keith Frederick (R-Rolla), were both passed by committee, but HB 1307 has been passed by the house and introduced into the senate. SB 519, sponsored by Sen. David Sater (R-Cassville), has already passed committee and awaits a floor vote.

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“This bills are going to make it harder for women to access safe abortion,” said Postal, who noted that the extended waiting period would create a barrier to abortion access for many women, not just in Missouri, but in surrounding states. “Many of our patients come, not just from all over Missouri, but from states surrounding Missouri. Some women are traveling hundreds of miles to get here,” she said. “Essentially we’re seeing women who are facing challenges accessing abortion care due to travel considerations, scheduling child care, and taking time off work. Doing that over a three-day period is just going to force the procedure later in pregnancy, and that poses a senseless risk to women’s health.”

Increasing the waiting period for abortions is a priority for Republicans in the state, who appear ready to use unconventional tactics to pass the legislation. The Republican leader in the senate, Ron Richard, reportedly said members of his party would attempt to use procedural legislative tactics to force a vote on extending the waiting period. 

Another bill that has reproductive rights advocates concerned would force women to view an ultrasound before having an abortion. It is already required that women receive an ultrasound at least 24 hours prior to terminating a pregnancy. HB 1148 and HB 1379, sponsored by Reps. Ron Hicks (R-St. Charles County) and Chuck Gatschenberger (R-Lake St. Louis), require the abortion provider to “review the ultrasound with the woman.” If the woman views the ultrasound in another facility, she must provide the abortion provider with written verification that it was conducted and viewed. The legislation does include exceptions for victims of rape or incest. Both bills are currently pending in the house Health Care Policy Committee. 

“We believe a woman should be informed of all her options, and given accurate medical and science based information about all those options,” said Postal. “That information should be given to a woman to help her make the best decision for herself, and not to coerce her into having an abortion or not having an abortion.”

There are a litany of other bills making their way through the legislature that would regulate reproductive health care in the state, which already has a highly restrictive regulatory regime on abortion care. For instance, lawmakers are considering a ban on the use of telemedicine to prescribe medication abortion, and restricting both private and public health insurance plans from covering abortions except in cases of medical emergencies. 

There are two bills, one that has passed committee and one awaiting a committee hearing, that would change the definition of medical emergency, removing “psychological or emotional conditions.” A ban on sex-selective abortions, much like the bill that was recently passed by the South Dakota legislature, is awaiting a committee hearing. Another bill awaiting a committee hearing would ban abortions performed for the purpose of providing fetal organs or tissue for medical transplantation. In addition, there are two bills, one of which passed committee and another that has passed the house and been introduced in the senate, that would change the parental notification requirement for minors seeking an abortion requiring that both parents be notified (with an exception for parents who have been convicted of abuse or who currently are restrained by a protective order).

Postal says Republicans have spent so much time attempting to restrict abortion in the state that measures that could expand access to health care for all state residents have been neglected. “We think they should spend time trying to pass a Medicaid expansion, something that would actually improve the health of people in Missouri,” she said.

Missouri Republicans have blocked the expansion of Medicaid under the Affordable Care Act. In February, the state senate voted 23 to 9 against expanding Medicaid, which would have reportedly extended health care coverage to 300,000 residents. This week, Republicans in the senate reaffirmed their opposition to expanding Medicaid, even as the Missouri Hospital Association and business leaders called for the expansion.

A study release by the Commonwealth Fund this week finds that many of the states that have refused to expand Medicaid coverage, mostly with Republican-controlled legislatures, would stand to benefit the most from expanded access.

And a report from the Missouri Health Advocacy Alliance predicts that Medicaid expansion would “improve access to health care and health outcomes for nearly 260,000 low-income Missourians who are currently left out of Missouri Medicaid.”

Postal says that some of the same lawmakers who are pushing anti-choice legislation are also blocking the expansion of Medicaid in the state. “These are the same people that really really don’t want to talk about Medicaid expansion, which the people now really want in Missouri,” she said. “They think that maybe if they talk about abortion, some more people won’t notice that we’re leaving behind more than 260,000 Missourians who need health care.”

Commentary Abortion

Standing Under Sprinklers, Missouri Activists Turn Tables on Anti-Choice Community

Pamela Merritt

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.

It remains unclear why a committee formed under the title “Sanctity of Life” failed to investigate why Missourians are at risk of being killed by gun-wielding toddlers, why gun deaths surpass deaths resulting from car accidents, or why Black women are three times more likely to have an infant die before the child’s first birthday.

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.

News Law and Policy

Missouri Governor Vetoes Sweeping Concealed Carry Bill, Republicans Plan Override

Michelle D. Anderson

In a four-page letter to Missouri Secretary of State Jason Kander, Gov. Jay Nixon said that he disapproved of SB 656 because citizens would be able to bypass the training, education, background check, and permit requirements currently needed to carry a concealed firearm in spaces where it is allowed.

Citing the safety of Missouri citizens, Gov. Jay Nixon (D) on Monday vetoed a bill that would have removed the vetting process for individuals seeking to carry a concealed firearm throughout the state.

In a four-page letter to Missouri Secretary of State Jason Kander, Nixon said that he disapproved of SB 656 because citizens would be able to bypass the training, education, background check, and permit requirements currently needed to carry a concealed firearm in spaces where it is allowed.

The Republican-controlled general assembly passed the bill on May 13, the last day of the legislative session.

The bill would have also allowed residents and nonresidents alike to carry a concealed firearm even when they have been denied a permit due to criminal offenses or because a state sheriff believed they posed a danger to the public, the governor’s office said in a news release Monday.

As noted in the Kansas City Star, “Under current Missouri law, gun owners may legally ‘open carry’ a weapon anywhere that does not expressly forbid the practice. Carrying a concealed weapon requires a permit.”

The bill also would have created a “stand your ground” law—the kind of policy often cited with regard to the murder of Trayvon Martin—and reduced the penalty for carrying a firearm into a prohibited space from a felony to a misdemeanor.

Additionally, the bill would have allowed those seeking a concealed carry permit to obtain a version of the document that never expires.

Nixon noted he signed a bill passed by the general assembly in 2013 that affirmed the role of Missouri sheriffs in issuing and denying concealed carry permits. In some cases, police chiefs can also issue permits.

“As Governor, I have signed bills to expand the rights of law-abiding Missourians to carry concealed and am always willing to consider ways to further improve our [carry and conceal weapon] process,” Nixon said. “But I cannot support the extreme step of throwing out that process entirely, eliminating sensible protections like background checks and training requirements, and taking away the ability of sheriffs to protect their communities.”

Nixon went on to say individuals who have pleaded guilty to a felony, 18-year-old high school students, and persons convicted of a misdemeanor assault, among others, could automatically could carry a concealed weapon “without scrutiny, training or notification,” if he did not veto the proposed law. Those individuals are currently forbidden from obtaining permits.

Missouri’s current concealed weapon process has been in place since 2003. The required procedure includes taking a mandatory course of at least eight hours that covers handgun safety, the principles of marksmanship, safe firearms storage, and the Missouri law.

In addition to classroom education, individuals must demonstrate that he or she can safety load and unload a handgun and successfully complete a live firing exercise that includes 20 rounds at a target, among other tasks.

Nixon’s veto garnered support from Kansas City Mayor Sly James, Kansas City Police Chief Darryl Forté, the Missouri Police Chiefs Association and the Missouri Fraternal Order of Police, according to Nixon’s office and local news reports.

The veto comes as Missouri and the rest of the nation grapple with mass shootings in Orlando, Florida, and San Bernardino, California, as well as the high number of firearm deaths nationwide.

Firearms led to 33,636 deaths nationwide in 2013, according to The Centers for Disease Control and Prevention’s most recent data.

Bill sponsor Sen. Brian Munzlinger (R-Lewis County) invoked those recent mass shootings in criticizing Nixon’s veto, saying lawmakers should be doing all they could to ensure “the citizens of Missouri have the ability to protect themselves,” according to the Kansas City Star.

Many Republican senators anticipate overriding Nixon’s veto when the general assembly returns to the state capitol in September, also according to the newspaper.

State senator and Secretary of State hopeful Will Kraus (R-Lee’s Summit), for example, said in a statement that he hoped lawmakers would override the bill later this year. House Speaker Todd Richardson (R-Poplar Bluff) reportedly made similar remarks.