With abortion now illegal in Missouri, providers look to next frontier to ensure access

Demonstrators gather at the Planned Parenthood clinic in St. Louis on June 24, 2022 in the wake of the U.S. Supreme Court’s decision overturning Roe v. Wade (Photo by Tessa Weinberg - Missouri Independent)
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(Missouri Independent) – Angela Huntington’s phone was constantly ringing off of the hook.

When Texas’ fetal heartbeat ban on abortions went into effect last September, the number of patients calling Planned Parenthood Great Plains jumped overnight. In August, about 150 patients received financial assistance and help. In September, that increased to roughly 850.

“I remember my inbox would grow, like every minute,” Huntington, one of the organization’s first patient navigators based in their Columbia clinic, said in an interview earlier this month. “It was like a chat strand with how many emails I was getting.”

While abortions haven’t been offered at the Columbia clinic since 2018, Huntington is part of a growing team of patient navigators that aim to be guides for patients in a post-Roe world.

Earlier this month, Huntington even helped an Oklahoma patient who did not have the means to pay for out-of-state travel get to Kansas City on a private plane flown by a volunteer to reach an appointment.

New regional centers that aim to continue to facilitate access to abortions — even if they don’t take place in Missouri — are gearing up in both Illinois and Kansas. The Regional Logistics Center has been operating in Fairview Heights since January, while the Center for Abortion and Reproductive Equity in Kansas plans to get off the ground as soon as possible.

Abortions are now illegal in Missouri after the U.S. Supreme Court’s watershed decision Friday overturning Roe v. Wade, which had guaranteed a constitutional right to the procedure. Only abortions conducted in cases of a medical emergency are permitted under the state’s trigger ban. Missouri’s last remaining abortion clinic ceased all abortion services Friday.

For abortion providers, who for decades have faced the increasing restrictions from the GOP supermajority that controls Missouri’s statehouse, Friday’s decision echoes familiar terrain.

“We’ve lived through this already,” Emily Wales, Planned Parenthood Great Plains’ CEO and president, said in an interview earlier this month, later adding: “It feels different because it is no longer death by a thousand cuts. And I think that’s what it has been living in Missouri.”

For anti-abortion advocates, a new frontier awaits.

“The battle’s not over, but the battleground has changed,” said Sam Lee, a longtime lobbyist with Campaign Life Missouri.

Lee said he expects there will be attempts to legalize abortion in Missouri, whether it’s through a lawsuit to find a right to abortion in Missouri’s constitution or a referendum to put the question before voters.

In anticipation of Roe v. Wade being overturned, Missouri lawmakers had proposed legislation this past session to ensure that no right to an abortion exists in the state constitution. In Kansas, a proposed constitutional amendment on the ballot this August will decide whether a constitutional right to abortion exists, potentially ushering in a wave of new restrictions if voters decide it doesn’t.

It remains to be seen in which direction Missouri lawmakers will choose to go in a post-Roe world.

Last year, Missouri lawmakers unsuccessfully attempted to bar certain forms of contraceptives from being paid for through the state’s Medicaid program and have signaled another push may be up for discussion. A proposal that gained national attention to allow private citizens to sue anyone who aids a Missourian in accessing an abortion — regardless of where the procedure occurs — failed to gain traction in the legislature.

“Anything that would harm the child or kill the child shouldn’t be in existence,” said Mary Maschmeier, founder of Defenders of the Unborn. “And birth control is that.”

Meanwhile, earlier this month, the National Right to Life Committee proposed a model abortion law for states to adopt once Roe falls. The proposed legislation goes beyond just criminalizing providers who perform an abortion by making it illegal for anyone to help someone obtain an unlawful one. Under the model legislation, that includes sharing information online or by phone on how to obtain one.

But for now, there are more immediate battles to be fought.

During a Friday roundtable discussion at the Planned Parenthood clinic in St. Louis, Mallory Schwarz, executive director of Pro-Choice Missouri, unveiled that a bill would be introduced by the St. Louis alderman to create a funding stream to support access to abortions by issuing $1 million in American Rescue Plan Act funds to groups working to provide transportation, lodging, childcare and more to patients in need of the procedure.

“This legislation makes St. Louis the fifth locale to provide municipal funding for access to abortion,” Schwarz said, “and the first municipality to provide funding for all-around pregnancy support, including access to doulas, lactation support and mental health care during pregnancy and postpartum.”

Lee said he believes the bill would violate state laws that prohibit public fundspublic employees and public facilities from being used to assist abortions. A provision in state law defines “public funds” as any money received or controlled by the state or a political subdivision, which can come from “federal, state or local taxes, gifts or grants from any source, public or private, federal grants or payments, or intergovernmental transfers.”

“There’s just no question in my mind,” Lee said, “and if the Board of Aldermen go through with it, then we will seek enforcement.”

Calling for federal action

Congresswoman Cori Bush, a St. Louis Democrat, urged the Biden administration on Friday to declare a national public health emergency and to increase funding to Title X health centers.

“This is an emergency,” Bush said, “and it demands emergency action.”

With the U.S. Supreme Court decision returning authority over abortion to the states, reproductive rights advocates in Missouri are renewing their calls for President Joe Biden’s administration to step up its enforcement of federal laws to ensure that Missouri’s safety net of reproductive health providers remains intact.

This past legislative session, Missouri lawmakers zeroed out funding to abortion providers and their affiliates through the state budget. It awaits Gov. Mike Parson’s signature. Planned Parenthood has already sued over restricted Medicaid payments as a result of a supplemental budget signed into law earlier this year.

In a May 12 letter, over 25 advocacy organizations — ranging from health care providers like Planned Parenthood to advocacy groups like Empower Missouri — urged the Centers for Medicaid and Medicaid Services to enforce federal law that stipulates Medicaid patients can choose any qualified provider to receive services from.

Advocates echoed those calls in Friday’s roundtable discussion with U.S. Department of Health and Human Services Secretary Xavier Becerra.

Becerra, a Biden appointee and former California attorney general, vowed to ensure states are abiding by federal laws outlining access to care.

“We want to make clear: We respect a state’s rights when it comes to its health and safety laws. Those are under the Constitution left mostly to a state” Becerra said, later adding: “We will make sure that if there’s federal law in place that protects the rights of individuals in this country to access care, that those rights are enforced.”

But HHS has yet to announce any action in Missouri’s case. A spokesperson for the federal agency previously said in April it was reviewing the policy.

Becerra said enforcement may entail legal action from the U.S. Department of Justice or ensuring the state is providing the services they’re required to in order to receive Medicaid funds.

By the end of Friday, shock at the decision had morphed to anger for reproductive rights advocates. Hundreds gathered at the Planned Parenthood clinic in St. Louis — which up until Friday had been the only place to get an abortion in the state — to chant, march and share calls to action.

Amidst the crowd propelled into the streets by Friday’s ruling,  a Washington University student named Rida said her thoughts were turning inward.

“It absolutely changes the way that I approach relationships. My body doesn’t feel like it’s my own. It feels like it belongs to Mike Parson somehow,” she said.

“It’s terrifying to feel like if I end up in a situation that’s completely out of my control, you know, god forbid if something happens to me if I’m assaulted, that there’s literally nothing I can do to help myself.”

(Photo by Tessa Weinberg – Missouri Independent)

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Tessa Weinberg


Tessa Weinberg covers education, health care, and the legislature. She previously covered the Missouri statehouse for The Kansas City Star and The Columbia Missourian, where her reporting into social media use by the governor prompted an investigation by the Attorney General’s office. She most recently covered state government in Texas for The Fort Worth Star-Telegram.