Missouri lawmakers blame vague wording of abortion ban for denial of emergency care

After a federal agency cited a pair of hospitals in Missouri and Kansas for refusing to provide an emergency abortion to a Missouri woman, state lawmakers are blaming the vagueness of the medical exception language in Missouri’s strict abortion ban.

“The problem here is less about what the law says and does and more about how the vague language causes a chilling effect on care for folks who are in the most desperate need like this,” said state Rep. Ashley Aune, a Kansas City Democrat.

The U.S. Department of Health and Human Services found Monday that the Freeman Health System in Joplin and at the University of Kansas Hospital in Kansas City, Kansas violated federal law when they denied care to Mylissa Farmer, a Joplin woman, in August 2022.

The investigation has offered renewed scrutiny of Missouri’s abortion ban — a 2019 law that went into effect minutes after Roe v. Wade was overturned last June. While abortions are still allowed in medical emergencies, some lawmakers say the emergency provision is poorly defined and could be interpreted differently by certain doctors.

Since it went into effect, the ban has cast a pall over women and the medical community as critics warn that Republican state legislators were making medical decisions instead of trained physicians.

Aune said Democrats had warned lawmakers that confusion about the vague language in Missouri’s abortion ban would jeopardize women’s health in emergency situations. She said the abortion ban is scaring providers into denying care for women whose lives are in danger.

Farmer, the Joplin woman, went into labor just before 18 weeks of pregnancy, and doctors told her the fetus would not survive and she was at great risk of infection. She was unable to get an abortion despite her condition, and eventually went to a clinic in Illinois to receive the care.

She told The Star on Monday this ordeal has been traumatic and definitely slowed her healing and grieving process for the loss of her daughter.

Farmer said she was terrified when the Roe v. Wade decision was overturned in June, and she knew hers would be one of the first cases to deal with the new laws. She said a doctor told her in the emergency room that women were going to die because of the new abortion bans.

“It really kind of set something off in my heart of how horrible it was what we were going through, that I did not want this to happen to any other woman,” Farmer said. “Nobody should ever have to face losing their child and their own life when something can be done.”

The National Women’s Law Center filed a federal civil rights complaint on behalf of Farmer with the Centers for Medicare & Medicaid Services in January, alleging the two hospitals violated the Emergency Medical Treatment and Active Labor Act, which allows for emergency medical care despite conflicting state laws.

State Rep. Jamie Johnson, a Kansas City Democrat, said Farmer’s case should prompt lawmakers to revisit the 2019 law.

“To make this more complicated and more tragic and more traumatic for her because she can’t terminate that pregnancy, which is going to terminate on its own, without threatening her life is absolutely egregious,” Johnson said.

State Rep. Doug Richey, an Excelsior Springs Republican, said he doesn’t think Missouri’s law on abortions is vague, and attorneys can always try to make that care when it suits their client.

“I think the law is pretty clear that elective abortions are illegal, and medical procedures that are necessary to save the physical life of the mother are not elective abortions.”

The U.S. Department of Health and Human Services found the Missouri and Kansas hospitals violated federal law in Farmer’s case because the abortion was emergency health care, the Associated Press first reported Monday.

In an emailed statement, Jill Chadwick, a spokesperson for the University of Kansas Health System said they follow federal and Kansas law to provide quality care to all patients, and the care provided to the patient was reviewed by the hospital and determined to be in accordance with their policy.

“It met the standard of care based upon the facts known at the time, and complied with all applicable law,” Chadwick said in the email.

The Freeman Health System did not respond to phone calls Monday.

According to a Monday news release, U.S. Health and Human Services Secretary Xavier Becerra sent letters to hospitals across the country reminding them of their duty to provide emergency care, and CMS will ensure hospitals are in compliance with the law before closing the case.

Farmer told her story in TV ads last year, criticizing then-Missouri Attorney General Eric Schmitt during the U.S. Senate race in Missouri for his support of the state’s abortion ban. Schmitt was elected to the U.S. Senate in November.