Missouri legislature’s attempt to exclude abortion providers from Medicaid struck down for the second time in four years by state’s Supreme Court


Missouri – The Missouri Supreme Court has once again stood firm against the state legislature’s attempts to block Planned Parenthood from receiving Medicaid reimbursements. This ruling, issued on Wednesday, marks the second time in four years that the court has struck down legislative efforts aimed at excluding abortion providers and their affiliates from the Medicaid program. The 2022 state budget explicitly aimed to allocate $0 for Medicaid-covered services provided by entities that offer abortions or are affiliated with abortion providers, despite the fact that nearly all abortions are already illegal in Missouri.

A History of Legal Battles

Planned Parenthood Great Plains and Planned Parenthood of the St. Louis Region and Southwest Missouri, the two affiliates operating in the state, have been at the center of this controversy. While they no longer provide abortions within Missouri’s borders, their counterparts in Kansas and Illinois continue to do so. The state’s attempt to defund Planned Parenthood through budgetary measures was declared unconstitutional by the Missouri Supreme Court, echoing a similar decision made in 2020.

Missouri’s Medicaid program, which serves low-income and disabled Missourians, prohibits funding for abortions except in limited circumstances. However, it has reimbursed Planned Parenthood for non-abortion reproductive health services, including STI and cancer screenings and contraceptives. Despite receiving no state funds for nearly two years due to ongoing legal disputes, Planned Parenthood clinics have continued to serve all patients, including those insured through Medicaid.

Advocates argue that withholding Medicaid funding from Planned Parenthood would adversely affect those most in need of care, while anti-abortion lawmakers maintain their stance against allocating state funds to any organization associated with abortion services. The legal contention culminated when Cole County Circuit Judge Jon Beetem ruled in December that the state’s actions were “ineffective and/or unconstitutional,” siding with Planned Parenthood’s argument that denying access to funds available to other health care providers was unjust.

Constitutional and Equal Protection Claims

During a Supreme Court hearing last November, discussions revolved around procedural issues, including whether Planned Parenthood should have sought resolution through the Administrative Hearing Commission first and whether the organization had the legal standing to sue. The state argued for administrative proceedings, while Planned Parenthood dismissed these as “meritless procedural roadblocks,” emphasizing the constitutional nature of their claims.

The Supreme Court’s ruling reinforced the circuit court’s judgment on Planned Parenthood’s equal protection claim, stating that even if there were no constitutional violation, the judgment would still stand due to the lack of contention from the state on this point.

In response to the ongoing legal battles, Missouri lawmakers have proposed new legislation aimed at altering state law to explicitly exclude Planned Parenthood from Medicaid reimbursements. However, Planned Parenthood’s legal representation has argued that changing the law is the only constitutional route to achieve such exclusion.

The Impact on Patients

Nearly 20% of Planned Parenthood’s patients in Missouri rely on Medicaid, highlighting the significant impact of these legal decisions on accessible health care services. The joint statement from Yamelsie Rodriguez and Emily Wales, presidents and CEOs of the respective Planned Parenthood affiliates in Missouri, praised the Supreme Court’s decision. They emphasized the critical nature of the services provided, such as cancer screenings, birth control, and STI testing, and condemned the political efforts to limit patient access to care.

As Missouri’s legal landscape continues to evolve, this ruling serves as a pivotal moment in the ongoing struggle for health care access and reproductive rights. While the Supreme Court’s decision upholds the rights of patients to access necessary health services through Planned Parenthood, the statement from the organization’s leadership suggests that the battle for patient access and health care equity is far from over.

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