After years of court losses and legislative stalemates, Republicans and anti-abortion advocates in Missouri are once again trying to block Planned Parenthood from receiving money through Medicaid.

A Senate committee debated legislation Wednesday that would change Missouri law to make Planned Parenthood ineligible to receive reimbursements from MO HealthNet, the state’s Medicaid program.

Though the organization says it hasn’t received any state funds for nearly two years, as legal fights over past GOP efforts continue to play out in court, anti-abortion advocates argued Missouri lawmakers must take action. 

“Budgets are moral documents,” said Samuel Lee, with Campaign Life Missouri, who testified in support of the bill before the Senate health and welfare committee. “And it’s immoral to spend money on organizations that provide and promote abortions.”

Nearly all abortions are illegal in Missouri, with the exception of medical emergencies. The two Planned Parenthood affiliates operating in the state – Planned Parenthood Great Plains and Planned Parenthood of the St. Louis Region and Southwest Missouri – no longer provide abortions in Missouri. But their clinics in Illinois and Kansas, as well as around the country, still do.

In 2020, the Missouri Supreme Court struck down language in a budget bill that excluded abortion providers or their affiliates from receiving Medicaid reimbursements. 

Lawmakers tried again in 2022, and a Cole County judge once again deemed the move unconstitutional. That case was appealed and is once again with the state Supreme Court.

State Sen. Lauren Arthur, a Democrat from Kansas City, reminded the committee that if Planned Parenthood received a Medicaid reimbursement, it would not be going to fund abortions. The organization’s clinics also provide other reproductive health care, such as cancer screenings, STI testing and treatment and contraceptives.

Advocates for planned Parenthood said cutting off Medicaid funding would only hurt those most in need of care.

“Even though the Missouri Supreme Court and the Circuit Court of Cole County have ruled that defunding attempts were unconstitutional, lawmakers continue playing political games to deny patients high-quality preventive care,” the state’s Planned Parenthood affiliates said in a joint statement following the hearing.

Planned Parenthood officials said they’ve continued treating all patients, even without reimbursements coming in.

Vanessa Wellbery, vice president of policy and advocacy for Planned Parenthood of the St. Louis Region and Southwest Missouri, said nearly 20% of the patients of Planned Parenthood affiliates in Missouri rely on Medicaid. 

“Any suggestion that patients could just go somewhere else or go to another provider is simply wrong,” Wellbery said. “There are not enough sexual and reproductive health care providers to fill the gap. This bill is discriminatory, it’s irresponsible, and it would issue a devastating blow to our public health safety net here in Missouri.” 

A fight to end public dollars to Planned Parenthood

Susan Klein, executive director of Missouri Right to Life, said anti-abortion advocates and lawmakers have worked hard to fight against public dollars going to Planned Parenthood. 

“We’re asking for pro-life protective language to go in statute to prevent our public dollars from going to an organization that is affiliated with the largest abortion provider in the United States,” she said. 

State Sen. Nick Schroer, a Defiance Republican sponsoring the legislation, assured his colleagues that there are enough health care providers to “pick up the slack” if Planned Parenthood ceases to exist in Missouri. 

“With all the money that’s coming in to put abortion back on the ballot, I think there’s a lot of money there,” Schroer said. “Why do they need our tax dollars?”

Schroer was referencing two coalitions that have launched initiative petitions campaigns hoping to enshrine abortion rights into the Missouri constitution. 

GOP renews push to make it harder to amend Missouri constitution by initiative petition

One coalition, Missourians for Constitutional Freedom, has raised more than $2 million to bankroll its efforts to gather more than 171,000 signatures before May in order to put the issue on the statewide ballot.  

Ryan Conway, legislative director for the Missouri Department of Social Services, said in the past three fiscal years, no money has been refunded to Planned Parenthood from DSS or MO HealthNet.

Arthur worried that cutting off Medicaid patients’ access to Planned Parenthood clinics could result in an even higher financial toll for the state. 

“If we are denying people access to the health care provider of their choice, in which case many times is Planned Parenthood, then you are creating a scenario where there may be more unwanted pregnancies,” Arthur said. “And that can cause additional expense for the state of Missouri if those patients go on to have pregnancies if they’re on Medicaid, their children are on Medicaid.” 

‘That safety net is going to break’

Maggie Olivia, a policy manager with Abortion Action Missouri, said she relied on Planned Parenthood health centers when she was uninsured. Even though she now has insurance, Olivia, who said she is also a survivor of sexual violence, continues to get gynecological care through Planned Parenthood.

“Planned Parenthood health centers are truly the only place I feel safe to access that level of intimate care,” said Olivia.

Michelle Trupiano, executive director with Missouri Family Health Council, Inc., said her organization’s network of providers helps about 40,000 patients across the state with family planning services, and Planned Parenthood is the provider for about half of those. 

She was among a number of people to testify about a medical provider shortage across Missouri. 

According to the Missouri Department of Health and Senior Services, primary health care provider shortages “makes it difficult for low-income, uninsured and geographically isolated Missourians to receive health care.“

On average, Trupiano said, it takes between three and six weeks for new patients in Missouri to get a doctor across the health council’s 68 safety net clinics, several of which are Planned Parenthood. 

Without Planned Parenthood, she said the wait for essential services would become months-long.

“If you put another hole in the safety net by eliminating Planned Parenthood, then that safety net is going to break and affect not just Planned Parenthood and how they keep their doors open to ensure care,” she said. “It’s going to affect every other safety net provider.”

State Sen. Mary Elizabeth Coleman, a Republican from Arnold and chair of the committee, asked a number of those who testified why the clinics couldn’t just drop their Planned Parenthood logo and affiliation and continue to operate. 

Wellbery, with Planned Parenthood, said it’s not as simple as dropping affiliation, adding the organization’s name is known and trusted.

The committee took no action on the bill Wednesday. 

CORRECTION: This story was updated at 10:31 a.m. to correct the spelling of Susan Klein’s name.