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.

A federal judge has temporarily blocked an anti-abortion law in Idaho restricting people's ability to travel to other states for the procedure.

During the 2023 legislative session, state lawmakers passed a law restricting "abortion trafficking," which it describes as an adult bringing a child across state lines for an abortion with the intent to conceal it from the child's parents or guardians.

Kelly O'Neill, staff attorney for the nonprofit Legal Voice, said a U.S. district court judge agreed to their preliminary injunction request, blocking the law while the case is decided.

"The judge agreed that the law is unconstitutional and that it violates First Amendment freedoms, the right to interstate travel, and that it's unconstitutionally vague and that it's confusing," O'Neill outlined. "A person can't determine what conduct is legal and what might land you in prison for a minimum of two years."

Idaho has some of the most restrictive abortion laws in the country, with the procedure banned in nearly every instance. While abortions have decreased in the state, research shows they've increased in neighboring states where it is protected since Roe v. Wade was overturned, such as in Washington.

O'Neill noted Idaho is not the only state where lawmakers are attempting to restrict abortion.

"There's a huge wave of anti-abortion laws coming out of Idaho in particular and every state in the nation," O'Neill pointed out. "People are working and doing their part to try to push back against those and restore options of choices and freedom, and this is certainly a way that we're helping to do that."

The suit challenging the Idaho law was filed in July. The parties involved gave oral arguments in September.


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A Kansas state court judge has blocked several abortion-related restrictions, in a decision which is bound to have an effect in neighboring Missouri.

It is being considered a win for the Center for Reproductive Rights and Planned Parenthood on behalf of Kansas abortion providers. The ruling blocks laws requiring providers to give government-scripted information to patients, and to impose mandatory waiting periods, which delay care.

Alice Wang, staff attorney at the Center for Reproductive Rights, argued the restrictions violate the Kansas Constitution, including the rights to abortion and free speech.

"These restrictions are especially harmful now that Roe v. Wade was overturned, and Kansas clinics are overwhelmed with patients from neighboring states where abortion is banned," Wang pointed out. "Abortion is a human right, and Kansans deserve accurate, candid medical information."

Judge Krishnan Christopher Jayaram wrote the restrictions only serve to "stigmatize the procedure and instill fear in patients that are contemplating an abortion, such that they make an alternative choice, based upon disproven and unsupportable claims."

Emily Wales, president and CEO of Planned Parenthood Great Plains, said patients should not be denied care because they printed a form in the wrong color or format.

"We have been forced to turn away patients for reasons that are medically wrong and ethically unjustifiable," Wales pointed out. "Despite post-Dobbs, we'll do as we've always done, provide our patients with expert care informed by best medical practices. Our first question will be about care, and not font size."

There have been hearings on multiple abortion-related laws in Kansas this year, including a ban on the most common procedure used after 14 to 15 weeks of pregnancy, known as dilation and evacuation. Abortion has been illegal in Missouri since last June.


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Maternal mortality, or death from pregnancy-related issues, nearly doubled in the U.S. between 2018 and 2021 - and a person who is Black is three times more likely to die from these issues than one who is white. Nebraska ranked 17th
for maternal mortality, with a higher rate than the national average during those years.

Ashlei Spivey, executive director of the organization "I Be Black Girl," which works in Nebraska for reproductive justice, said data show some practitioners take Black patients' complaints of pain less seriously, with some erroneously believing Black people have a higher pain tolerance.

"How can we make sure medical practitioners - no matter if they're the OB or the phlebotomists - are getting cultural awareness training, that they're being in tune to the experiences of all the different types of patients that they're seeing, especially their Black patients,?" she said.

Awareness-raising events during this Black Maternal Health Month will culminate with a Reproductive Justice Summit on October 27th. Spivey said the speakers and breakout sessions will cover a number of issues that affect "reproductive well-being," including housing, transportation and wages. The keynote speaker will be renowned activist, author and professor Angela Davis. Registration closes after today.

Spivey said one of the steps they're taking is working with partner agencies to increase the number of doula-friendly
hospitals in the state.

"They're a trained companion that can help, and know that pregnant person more intimately," she explained. "And so they know this is this person's birth plan, how can we make sure that it's honored, and help that person have power and choice when working with their medical team - to address some of the things around not being heard."

Research shows doulas have a positive impact for both mothers and babies, and several states now include Medicaid coverage for doula care.

Spivey sees the "transactional" nature of U.S. healthcare - factors like insurance billing, what's covered and what isn't, and how many patients a practitioner is expected to see in a day - as contributing to the risks for patients.

"I think we need to remove that as transactional and really spend time with people, understanding what they're needing, and also making sure people feel empowered to hold doctors accountable. You know, people feel like they're the experts - they don't want to question," she continued.