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Though state Senators fended off a bid by hardline conservatives to pull Medicaid funding from Planned Parenthood, Missouri Republicans are not done trying to remove the provider from the state health program.
Republican Senators said they’ve been assured that Gov. Mike Parson’s administration is likely to pursue regulatory action to eliminate the organization from any role in Medicaid.
In the House, which begins meeting in special session Tuesday to take up renewal of a critical tax that pays for the health program — passed by the Senate early Saturday — lawmakers will push separate legislation to ban payments to Planned Parenthood.
“Anti-abortion politicians continue to threaten this vital health care program for people with low incomes by considering illegal ‘defunding’ measures against Planned Parenthood,” Planned Parenthood Advocates in Missouri said in a Monday statement.
Either course of action could land Missouri in a fight with the Biden administration, which has indicated it opposes efforts to block family planning providers from federally-funded programs. The administration has not addressed Missouri’s specific efforts, but some lawmakers suspect it will push back.
“I’m not sure the Biden administration is not looking for a state to make an example of,” said Sen. Mike Cierpiot, a Lee’s Summit Republican.
Under state and federal law, Medicaid does not cover abortions. But Planned Parenthood’s status as Missouri’s sole abortion provider — at its St.Louis clinic — has spurred numerous attempts by hard-right Republicans to remove the organization entirely from its role in delivering taxpayer-funded health care to low-income women.
Under Medicaid, its Planned Parenthood’s 11 family planning clinics across the state provide birth control, sexually transmitted disease treatments, cancer screenings and other non-abortion services.
After a bitter impasse, the state Senate Saturday rejected the latest attempt, led by Lake St. Louis Sen. Bob Onder, to attach the ban on payments to Planned Parenthood to the renewal of the medical provider tax that generates billions of dollars for the state’s Medicaid program.
Compromise language specifies that the program also does not cover the abortion pill.
After the Senate vote, Republicans rushed to declare that the state will still move to exclude the provider.
“Leaders in the Missouri House and Senate are working closely with Governor Parson to put a real plan in place to, once and for all, defund Planned Parenthood in the state of Missouri,” Majority Leader Caleb Rowden, a Columbia Republican, wrote in a statement on Facebook.
He and Senate President Dave Schatz, a Sullivan Republican, said in a joint statement after the vote that Parson had made a “commitment to take necessary executive action” that would “deliver the knockout punch” on Planned Parenthood funding.
Parson’s spokeswoman Kelli Jones did not respond to an inquiry Monday on details of the executive action being considered. Rowden and Schatz also did not return calls for comment.
Lawmakers were unwilling to pass the Planned Parenthood ban in the tax renewal bill because termination of the tax could lead to the collapse of the state’s entire Medicaid program. But Republicans learned the Parson administration could instead rewrite Medicaid rules on its own in a way that would restrict an abortion provider from the program, Cierpiot said.
“The good thing about that from our point of view is if the rules are found to be beyond what is possible, we can try again or try different methods,” he said. “I just think it’s a much better way to do it. Nothing is threatening funding.”
How the Biden administration would respond to a proposed rule restricting the affiliates of abortion providers is unclear. Federal law prohibits states from excluding qualified Medicaid providers without reason. But the Trump administration in 2018 rescinded Obama-era guidance to states that had specified they could not exclude providers for being abortion clinics. Federal appeals courts have allowed Republican administrations in both Arkansas and Texas to cut ties with Planned Parenthood.
“It’s an open legal question,” Missouri anti-abortion lobbyist Sam Lee said last week.
Planned Parenthood Advocates in Missouri has launched a petition asking the Biden administration to weigh in on Missouri’s efforts.
“We’re calling on the pro-reproductive health White House to make it clear every Missourian who relies on Medicaid has the freedom to choose their provider,” it states.
Meanwhile, House Republicans are rushing this week to push the Planned Parenthood ban the Senate rejected on Saturday.
In addition to hearing the bill to renew the medical provider tax, which must pass by July 1 before Parson enacts drastic budget cuts, the House Budget Committee is scheduled to hear two pieces of legislation fully excluding Planned Parenthood or other abortion clinic affiliates from Medicaid and other public funding.
It is sponsored by O’Fallon Rep. Nick Schroer, who is among several House Republicans who have said they want to restore Onder’s language alongside passage of the tax renewal.
Lawmakers in 2018 and 2019 included this ban in the state budget, and the state withheld more than $1 million in payments from Planned Parenthood affiliates before the Missouri Supreme Court ruled that lawmakers could not pass that legislation through the state budget.
The Star’s Jonathan Shorman contributed reporting.