With most abortions illegal in Missouri, few expect new bills will get traction this year

Nearly every abortion is illegal in Missouri, but that hasn’t slowed the pace of anti-abortion legislation in the Missouri statehouse. 

As lawmakers return to the Capitol for the 2024 legislation session, Republican lawmakers have already filed numerous bills seeking further restrictions on abortion and abortion providers. Yet even the staunchest anti-abortion activists concede it’s unlikely they’ll get much traction this year. 

Sam Lee, a longtime anti-abortion activist with Campaign for Life, said after anti-abortion lawmakers and activists spent the last 50 years trying to overturn Roe v. Wade, many are left asking what’s next.

“I think the pro life movement is trying to figure that out,” he said. “I don’t think there’s a clear answer.”

That energy could shift to other reproductive health care proposals, such as tackling Missouri’s high maternal mortality rate, expanding testing for sexually transmitted diseases and extending insurance coverage for things like in vitro fertilization.

Looming in the background is a pair of initiative petition campaigns seeking to amend Missouri’s constitution to legalize abortion. Those efforts will likely fuel another push by Republicans to make it harder to amend the constitution through the initiative petition process. 

Vanessa Wellbery, vice president of policy and advocacy with Advocates of Planned Parenthood of the St. Louis Region and Southwest Missouri, said despite Missouri already having one of the most restrictive abortion laws in the country, some Republican lawmakers are “doubling down their attacks on abortion, reproductive care more broadly and pregnant people themselves.”

Some bills buck that trend “and support pregnant people and parents,” Wellberry said, but “they don’t come close to undoing the years of pain inflicted on Missourians.”

Abortion debate

State Sen. Andrew Koenig, a Republican from Manchester, is proposing legislation to make it illegal for employers to assist employees in getting abortions. Those that did anyway could no longer be able to be awarded grants, tax credits or other financial benefits from the state. 

In June 2022, the Kansas City Council voted to reimburse city employees or their dependents for any expenses incurred while traveling to obtain health care outside of Missouri. The following month, St. Louis Mayor Tishaura Jones signed a measure that sets aside $1 million to help finance travel to abortion clinics.

“State leaders restricting women’s healthcare is not new, but the proposed bill will be uniquely horrifying for any Missouri woman of reproductive age who may seek healthcare, including the millions of Missouri women who live within driving distance of the state line,” Kansas City Mayor Quinton Lucas said in a statement. “The state trying to track healthcare decisions made by female employees outside of Missouri is unconscionable. Women are not slaves to their employers, the state, or their husbands. The proposed bill works hard to make them so.”

Dave Evans, director of communications for Koenig, said it’s too early to be “drilling down too far on this bill,” since it’s the first time it’s been filed and the language will likely change. 

“If there’s some reasonable changes to be made to this thing,” Evans said, “I’m sure he’ll entertain them.” 

Another bill, filed by Republican state Sen. Nick Schroer of Defiance, would exclude abortion facilities or affiliates from the state’s Medicaid program. 

Meanwhile, state Rep. Emily Weber of Kansas City was among a handful of Democrats who again introduced legislation hoping to increase access to abortion in response to Republican legislation she said is driving Missourians out of the state.

For the fourth year in a row, Weber filed the “Respect People’s Abortion Decisions Act,” would legalize abortion prior to fetal viability. She knows it won’t go anywhere this year. But she hopes it could someday.

“When the supermajority gets broken and we gain the gavel back, we can finally say, ‘hey, these bills have been filed for so many years, finally they can get the hearing they deserve,’” Weber said.

State Sen. Mary Elizabeth Coleman, a Republican from Arnold who filed legislation seeking to preempt any federal action that would legalize abortion in Missouri, said she would be surprised if any abortion-related legislation moved forward this session. 

She said the fact that Democrats are filing legislation seeking to end the abortion ban is an indicator that they don’t have faith the initiative petition efforts will get much traction this year.

One campaign, launched by Republican Jamie Corley, would make abortion legal up to 12 weeks of pregnancy and add exemptions for victims of rape and incest.  A separate coalition, called Missourians for Constitutional Freedom, filed eleven other initiative petitions that include varying abortion restrictions, ranging from 24 weeks gestation to “fetal viability.”

“There’s just a lack of interest and investment in the state for initiative petition from the national donors, and that’s certainly exaggerated by the discord in the pro-aboriton movement,” Coleman said. “Meanwhile the pro-life movement is united in fighting all 17 initiative petitions.” 

House Minority Leader Crystal Quade, a Democrat from Springfield who is running for governor, filed legislation seeking to put the most expansive version of the 11 initiative petitions filed by Missourians for Constitutional Freedom on the 2024 ballot. 

The language would give voters the option of taking down Missouri’s abortion ban with no gestational limits, and it would protect patients and medical providers from prosecution. She doesn’t expect it to pass, but she’s hopeful voters will eventually have the opportunity to vote on abortion. 

“Republicans have seen time and time again that they’ve gone too far, that voters are ready to hold them accountable for taking away freedoms we’ve long had,” Quade said. “ … But you still have a large portion of Republicans wanting to go further.” 

She was referring in particular to legislation filed by Sen. Mike Moon, a Republican from Ash Grove, and Sen. Bob Titus, a Republican from Billings, which would allow prosecutors to charge women who got abortions in Missouri with murder. The bills, versions of which have been filed in previous years in Missouri, made headlines last month, drawing outrage from both sides of the abortion debate. 

Titus withdrew his bill after the backlash.

“It gives the perception that people who are pro-life don’t care about women. That they want to punish women,” said Lee, with Campaign for Life. “That measures that regulate or restrict abortion are in essence punitive as opposed to protective of the unborn child and the mother’s health, and that is unfortunate.”

Maggie Olivia, a policy manager with Abortion Action Missouri, said she views legislation as a way to desensitize lawmakers and constituents. 

She said such bills, even with zero prospects of becoming law, sow fear and confusion among some Missourians. She worries some women might resort to terminating their own pregnancies in unsafe manners out of fear of being discovered and someday prosecuted.

“That’s a big consequence of proposing and allowing debate on these bills, is they could put real Missourians right now in physical danger because they’re too afraid to seek out safe options for themselves,” Olivia said.

Other reproductive health care bills

With debate on abortion rights likely tabled for the time being, other reproductive health care proposals could get more attention. 

Missouri continues to see some of the highest rates of maternal mortality in the country. 

Last month, Gov. Mike Parson announced the Missouri Department of Health and Senior Services would invest more than $4 million in trying to improve health outcomes for women during pregnancy and postpartum. 

State Sen. Barbara Washington, a Democrat from Kansas City, said the announcement further fuels her optimism that some of her bills focused on studying and improving maternal mortality rates could gain traction this year.

She is among lawmakers who are also hoping to make doulas and midwives more accessible to all Missourians.

“I see folks that are dying, possibly losing their life, that look like me,” Washington said. “So we definitely need to do something to reduce these numbers.”

Other legislation includes an attempt by state Sen. Tracy McCreery, a Democrat from Olivette, and state Rep. Patty Lewis, a Democrat from Kansas City, to increase insurance coverage for self-administered hormonal contraceptives, such as the birth-control pill, so Missourians could fill a year’s supply at a time. 

State Rep. Sean Pouche, a Republican from Kansas City, filed a bill that would create a one-time $2,200 tax credit for families after a stillbirth. State Rep. Jo Doll, a Democrat from Webster Groves,filed a bill hoping to mandate mental health screenings during each trimester of pregnancy. 

Bills that would require pregnant women be tested for syphilis, Hepatitis B, Hepatitis C and HIV 28 weeks into pregnancy in addition to testing already done in the first trimester, were filed by state Rep. Melanie Stinnett, a Republican from Springfield, and state Sen. Elaine Gannon, a Republican from De Soto. 

Congenital syphilis rates have been on the rise nationwide, including in Missouri, where cases rose from two in 2015 to 63 in 2021, according to the state health department.

State Rep. LaDonna Appelbaum, a St. Louis Democrat, for the second year in a row proposed legislation that would mandate insurance coverage for “the diagnosis and treatment of infertility including, but not limited to, in vitro fertilization, uterine embryo lavage, embryo transfer, artificial insemination, gamete intrafallopian tube transfer or zygote intrafallopian tube transfer, and low tubal ovum transfer.” 

The one cause both Republicans and Democrats appear to support is eliminating the luxury tax on diapers and feminine hygiene products.

Muriel Smith, executive director at St. Louis Area Diaper Bank, said after years of advocating for such legislation, she believes this year there may be a chance at success. 

“In some ways I think this particular issue with this bill is an easy thing for people to support,” she said, “and I hope that it can open the door to other opportunities for bills that will help support reproductive rights. It’s one step at a time.”