Missouri conservatives, empowered by GOP control, seek more ideological victories

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Abortion access has all but disappeared from Missouri. A 2019 law signed by Gov. Mike Parson bars the procedure after eight weeks of gestation — a near total prohibition.

While a federal court has blocked the ban from going into effect as a lawsuit by abortion rights advocates moves forward, women seeking to end their pregnancies have fled to Illinois and Kansas. At Missouri’s sole abortion clinic, Planned Parenthood of the St. Louis Region, 50 surgical abortions were performed in 2020, down from the roughly 1,400 the year before.

Federal law bars the use of Medicaid funds for abortions.

And yet, for the Missouri Republican Party’s far-right wing, it’s not enough. As legislators convened a special session Wednesday to renew a hospital tax critical to funding Medicaid, abortion politics hangs heavily over the proceedings.

A group of conservative GOP senators is demanding a ban on Medicaid coverage of certain contraceptives, including Plan B and IUDs, and a prohibition on Medicaid dollars going toward Planned Parenthood in exchange for supporting the tax, which provides upwards of $4 billion a year to fund Missouri’s $12 billion Medicaid program and expires in September.

GOP supermajorities in the General Assembly this year have empowered its most conservative lawmakers, who are seeking ideological victories on abortion and gun rights — areas where Republicans have already left a strong imprint. They are raising the specter of liberal gains under President Joe Biden, fueling a sense of crisis as they pursue policies with real-world consequences.

A bitter battle between Republicans lies ahead, with Parson promising steep spending cuts if the tax, called the Federal Reimbursement Allowance or FRA, isn’t approved by July 1 when the new budget year begins.

While an agreement has been reached among Republicans on birth control, they remain divided over efforts to target Planned Parenthood, whose affiliates operate 11 family planning clinics across the state in addition to the St. Louis facility. For now, Senate Republicans are trying to forge consensus within their party, but the size of the supermajority caucus has made the process unwieldy.

On Planned Parenthood, Parson has limited the scope of the session to only blocking the organization from receiving payments from the Uninsured Women’s Health Program, a program administered by Missouri’s Medicaid program, which covers contraception and testing for sexually-transmitted infections.

That’s angered conservative senators who want a more sweeping ban, even though existing law already blocks Medicaid from paying for abortion.

“Governor Parson said he is 100% pro-Life,” Sen. Mike Moon, an Ash Grove Republican, said, referring to a comment by the governor this week.

But Parson’s comment “does not support his unwillingness to sign a bill that includes language to defund Planned Parenthood” and prohibit reimbursement for drugs “which will abort pregnancies,” Moon said. He also wants to tax the endowment funds of Missouri universities that train doctors in performing abortions.

Parson has warned recalcitrant lawmakers in stark terms against “moving the goalposts” to push for more.

“Let me be clear: I am pro-life. I have supported pro-life measures my whole career and always will,” Parson told reporters on Monday. “However, narrow political interests cannot be allowed to hold hostage vital health care funding and the success of our economy.”

Accusations of political posturing

Moon and others, effectively ignoring Parson’s narrow call, are persisting in their push for more aggressive limits on Planned Parenthood.

Sen. Bob Onder, a Lake St. Louis Republican leading the opposition to Planned Parenthood, said lawmakers can pass whatever bills they want.

During a speech on the Senate floor, Onder said the FRA allows senators to “keep the leverage” over Medicaid.

“Every one of you ran as a pro-lifer. None of you ran on the principle that we must fund America’s largest abortion provider. All of you made campaign promises,” Onder said, addressing his fellow Republican senators. “The question is whether you meant them and whether you have the political will and the courage to do the right thing and honor those promises.”

The focus on Planned Parenthood has taken on new urgency among Republicans because Biden’s proposed budget omits the Hyde Amendment, a provision that bans the use of federal taxpayer dollars to pay for abortion except in rare circumstances. The measure has been continuously approved by Congress for decades, however, and presidential budgets are almost always modified significantly by Congress.

Abortion opponents contend its absence from the president’s proposal, coupled with a Democratic-controlled Congress, puts the amendment in real jeopardy. Attorney General Eric Schmitt, who is running for U.S. Senate, joined 21 other attorneys general on Tuesday in calling on Congress to keep the provision.

On Wednesday, multiple Republican senators cited the feared lapse of the measure as a reason for action now against Planned Parenthood.

“Really, that’s one of the reasons that we are here. I believe in life, I believe the majority of Missourians support life and do not want to see abortion,” said Sen. Denny Hoskins, a Warrensburg Republican.

Medicaid requires patients to have a “free choice” of their medical provider as long as it is one considered qualified. Last fall, however, a federal appeals court ruled in favor of Texas for restricting Planned Parenthood from its Medicaid program. Language in the state budget lawmakers sent Parson in May already restricts the state family planning program from making payments to Planned Parenthood.

Democrats, abortion rights advocates and others decried the push from the Republican lawmakers as political posturing and said they were falsely conflating abortion, which ends a pregnancy, with emergency contraception, which either prevents fertilization of an egg or prevents a fertilized egg from implanting in the uterus.

“The medical and scientific communities are clear on this: Emergency contraception and birth control prevent pregnancy — they do not end it,” M’Evie Mead, director, Planned Parenthood Advocates in Missouri, said. “Whether politicians understand this or not only underscores that they have no place in a discussion that should be between a patient and their health care provider.”

Sen. Brian Williams, a St. Louis County Democrat, noted past General Assemblies had passed the FRA without interruption — and without the birth control and Planned Parenthood changes some Republicans now want. During its 30-year history, the tax has always been renewed during the regular session until this year.

“I think this is about political pandering. I think this is about folks wanting to make headlines over policy,” Williams said.

Critical race theory attacked

Some Republicans quickly seized on the session to send messages on issues unrelated to Medicaid, or even abortion.

Minutes after senators were gaveled to order, Hoskins introduced a bill attacking critical race theory, the decades-old academic concept which scholars say provides a lens for examining how race and inequality impact criminal justice, law, health care, housing and other essential American institutions. Onder said CRT was probably the number one issue he had heard about from constituents since the regular session ended in May.

The special session’s immediate turn toward divisive issues such as abortion and critical race theory was in line with a continuing focus on culture war-type issues among many GOP lawmakers.

This spring, the General Assembly passed and Parson signed the Second Amendment Preservation Act, a new state law that declares many federal gun regulations, including those covering weapons registration, tracking and possession of firearms by some domestic violence offenders, “invalid” in Missouri.

While senators didn’t speak about guns on Wednesday, the immediate injection of CRT into the session raised at least the possibility lawmakers could also introduce other issues, such as firearms. Parson and Schmitt vowed robust defenses of the law after being warned about its constitutionality by the U.S. Department of Justice.

“Throughout my career, I have always stood for the Constitution and our Second Amendment rights, and that will not change today or any day!” Parson wrote last week.

The law was a signature achievement of Republicans this spring and had been sought by gun rights advocates for years. Its passage, coming just months after Biden’s election, marked the culmination of a decade of discussion about state authority and vague fears, first voiced under President Barack Obama, of a future gun confiscation by Democrats.

But Congress hasn’t been able to pass even meager restrictions in recent years. And Missouri has among the nation’s most permissive gun laws. In 2020, Guns & Ammo magazine ranked the state the 12th most gun-friendly in the nation.

Still, the new law has already resulted in real-world effects. The police chief in O’Fallon, outside St. Louis, resigned last week over the law. St. Louis City and County are jointly suing the state, arguing the law is unconstitutional. Partnerships between local and federal law enforcement may be threatened.

“They need to recognize their mistake,” former O’Fallon Chief Philip Dupuis said last week, “and immediately go back to the drawing board.”

The Star’s Jeanne Kuang contributed reporting