GOP-controlled MO House advances bill to block Medicaid money from Planned Parenthood

The Republican-controlled Missouri House advanced a bill on Wednesday that would block state Medicaid dollars from going to Planned Parenthood, even as abortion remains illegal in the state.

Lawmakers gave initial approval to the bill, filed by Rep. Cody Smith, a Carthage Republican running for state treasurer, on a voice vote. It will need one more vote before heading to the Senate.

Smith said that the bill is a continuation of Republican efforts to block Planned Parenthood’s two affiliates in Missouri from receiving taxpayer dollars through the state’s Medicaid program. The legislation comes after the Missouri Supreme Court ruled earlier this month — for the second time in four years — that lawmakers cannot use the state budget to strip Medicaid funding from the organization.

“Through a series of attempts at that through the budget process and a couple of Supreme Court decisions, we have been stymied in those efforts,” Smith said. “This bill would simply seek to codify that in statute.”

House Democrats opposed the measure during debate on Wednesday. They said that the bill would block Medicaid recipients from accessing other services provided by Planned Parenthood including mammograms, STI testing and birth control.

“To say that this bill today is about abortion — it isn’t,” said Rep. Emily Weber, a Kansas City Democrat. “This is about Missourians’ access to birth control, to cancer screenings, to annual exams, to STI testing and treatment.”

Missouri bans abortion in nearly all circumstances under a 2019 law that went into effect after the U.S. Supreme Court struck down the federal right to the procedure in 2022. Missouri also has not sent state dollars to Planned Parenthood in roughly two years, according to Senate documents.

Federal rules on state Medicaid programs

Rep. Paula Brown, a Hazelwood Democrat, said she was also concerned that the bill would run afoul of federal rules governing state Medicaid programs. She cited a piece of federal regulation that says that Medicaid users cannot be denied freedom of choice of qualified family planning service providers.

She said that even though the provision hasn’t been enforced against other states that have passed similar measures, that could change at any time. If so, she said, it would endanger a significant chunk of funding for the state’s Medicaid program.

“Law really is the law, whether it’s being followed or not,” Brown said. “My concern is that we continue to get Medicaid funding overall in our budget … I hope you’ll look at that, because that really is a big concern.”

Smith, the Carthage Republican representative, said that he hadn’t heard of the statute Brown was referencing, but told Brown that he would look into it.

In a joint statement issued Wednesday, the organization’s two affiliates pointed to the recent court ruling against efforts to block funding through the state budget. The legislation was “another direct attack on Missourians, playing politics with their ability to access essential, life-saving health care like birth control, cancer screenings, STI testing and treatment, and more,” the statement said.

“Planned Parenthood continues to treat patients — without reimbursement — regardless of the patients’ ability to pay or insurance status, because every person must have the right to get care from the health care provider of their choice,” the group said.

Medicaid tax bills and abortion

The House’s decision to take up the legislation was widely viewed in the Missouri Capitol as a way to appease a hard-right faction of senators who have attempted to attach similar anti-abortion language to a bill that would reauthorize a series of crucial taxes that fund the state’s Medicaid program.

Members of the hard-right Missouri Freedom Caucus in the Senate have vowed to use the tax bill, known as the Federal Reimbursement Allowance, or FRA, to block public funding from going to Planned Parenthood.

Sen. Bill Eigel, a Weldon Spring Republican, and Freedom Caucus member, previously said he would block any version of the Medicaid tax bill that didn’t include the anti-abortion language.

Sen. Denny Hoskins, a Warrensburg Republican, said Wednesday that he would join Eigel in blocking the legislation unless the anti-abortion language were either included in the FRA, or a provision containing the same language was signed into law by Republican Gov. Mike Parson first.

His preference, Hoskins said, would be for the anti-abortion language to be combined into the tax renewal legislation.

Hoskins cited the last time the FRA was set for renewal in 2021, when a group of hard-right Senators derailed the bill over the same pro-life measures at issue this session.

“Unfortunately, the FRA bill made it through and the pro-life bill to defund Planned Parenthood did not make it through,” Hoskins said. “We had secured promises that both of them would go or neither of them would go.”

Not renewing the FRA would lead to an estimated loss of $4.3 billion in state and federal Medicaid funds in fiscal year 2026, according to an analysis by the Missouri Budget Project, a nonprofit that analyzes fiscal policy.

A loss of that magnitude would force lawmakers to make cuts across the board, including to education and other priorities, to keep Medicaid running.