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.

Voters across the country approved a majority of measures in November to affirm abortion rights and supporters of an initiative to legalize abortion in Idaho said they are feeling momentum.

Voters approved seven of 10 state abortion-rights measures, including in Montana. A Florida measure received a majority of votes but did not reach the state's 60% threshold for passage.

In Idaho, pro-choice advocates are waiting for approval to collect signatures on a 2026 measure which would allow access to abortion until viability of the fetus.

Melanie Folwell, executive director of Idahoans United for Women and Families, is leading the effort.

"If there's anything that was very clear in November's election, it's that abortion amendments and abortion laws -- laws that expand access to reproductive options -- do well at the ballot, even in very 'red' states," Folwell asserted.

Idaho is one of six states with a near-total abortion ban. Folwell noted her organization is awaiting approval from the attorney general's office and could start collecting signatures by the end of January.

However, unlike many other states allowing voter initiatives to amend the state constitution, Idaho does not. If approved for the ballot, the abortion access measure would mean passing legislation, which in turn means legislators could repeal it. Folwell argued it is unfortunate, when people have been telling lawmakers since Roe v. Wade was overturned about the negative effects of banning abortion.

"They've heard from doctors, they've heard from health care systems, they've heard from patients themselves -- from women who have suffered needlessly as a result of these laws -- and they've done nothing," Folwell observed. "They've had two legislative sessions to do something. They've done nothing. And we think there's an imperative to just take this question to the people."

If the measure is approved to collect signatures, it would need 6% of signatures from registered voters from at least 18 of the state's 35 legislative districts, a total of about 70,000 signatures before April 30, 2026.


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Health clinics in New England and elsewhere are coping with a sharp uptick in requests for long-acting contraceptives in the wake of the election.

Planned Parenthood centers in New Hampshire, Maine, and Vermont report more than double their weekly average appointment inquiries for intrauterine devices - or IUD's - and the birth control implant.

Planned Parenthood of Northern New England CEO Nicole Clegg said the organization had exceeded its monthly average for vasectomy consultations by mid-November.

"There's a lot of anxiety," said Clegg, "that people have around whether or not they're going to have access to their preferred birth control choice."

Clegg said patients are also calling with concerns about the availability of gender-affirming care.

She said the increase mirrors what the organization experienced after President-elect Donald Trump's first win in 2016, and the eventual overturning of Roe v. Wade in 2022.

In New Hampshire, abortion remains accessible up to twenty-four weeks of pregnancy, but health care advocates note that state law does not expressly protect abortion rights and that anything could change under the new Republican trifecta at the statehouse.

Clegg said New Englanders are already showing a heightened interest in volunteering at health centers to ensure patients can get the care they need.

"We've had these intense fights before," said Clegg, "and time and time again the American public has stood up for Planned Parenthood and our rights. We think they'll do the same again this time."

Clegg said a loss of federal funds would reduce peoples' access to vital, preventative health care services.

The co-leaders of Trump's new Department of Government Efficiency have already vowed to cut $300 million earmarked for groups like Planned Parenthood, which they claim pursue a progressive agenda.





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A majority of South Dakotans have voted to maintain a strict abortion ban but other factors are shifting the landscape for reproductive care in the state.

Of the 10 states voting on abortion during the 2024 election, South Dakota was one of three to keep a ban in place.

Kim Floren, director of the Justice through Empowerment Network, which provides financial assistance to people seeking abortions, said the state's view on the issue is not new but concern is growing over how the federal government may affect reproductive rights.

"I'm feeling the panic from people who are in areas that maybe haven't experienced what we've experienced as far as barriers go," Floren noted. "The reality is that we as a community can figure out how to take care of one another."

The Justice through Empowerment Network provides assistance with travel and transportation, child care, lodging, interpreters, birth control and medical procedure funding. Floren pointed out the organization supports 30 to 40 people per month. The final tally for Amendment G, which would have established a right to abortion in the state's constitution, was 41% for and 59% against.

South Dakotans voted in 2006 and 2008 against near-total abortion bans but Floren stressed since then, President-elect Donald Trump's first term made people feel "emboldened to be more vocal." Still, she acknowledged his second term will begin in a different context than his first.

"Before Dobbs, we did not have all of these reliable, safe websites where you can order abortion pills from and have them sent to your house for extremely cheap," Floren observed. "In some ways, access here has gotten better."

Floren added Gov. Tim Walz of Minnesota will return to his post after running for vice president on the Democratic ticket. Walz in 2023 signed a bill protecting patients who travel to Minnesota for abortion care and their providers from legal penalties in other states.


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