Missouri Senate passes bill to block Medicaid reimbursements to Planned Parenthood

The Republican-controlled Missouri Senate early Wednesday passed a bill to block Medicaid dollars from going to Planned Parenthood despite fears that the measure would hurt those who use the organization for a broad swath of services.

The legislation bars any public funds, including Medicaid reimbursements, from going to abortion facilities or their affiliates, including Planned Parenthood, despite the fact that abortion is illegal in nearly all circumstances in Missouri.

The Senate approved the bill, filed by Rep. Cody Smith, a Carthage Republican running for treasurer, on a party-line vote of 23 to 10. It now heads back to the House.

“This bill is, again, one that’s going to be putting into state statute to make sure that anyone who is affiliated with an abortion provider, that Planned Parenthood will no longer be eligible for the Medicaid program,” said Sen. Mary Elizabeth Coleman, an Arnold Republican who handled the bill in the Senate.

Coleman, who is running for secretary of state, told her colleagues Tuesday afternoon that she would not yield the floor until they agreed to pass the bill.

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 Missouri Supreme Court ruled in February — for the second time in four years — that lawmakers cannot use the state budget to strip Medicaid funding from the organization.

Senate Democrats spent 11 hours filibustering the legislation, arguing that Republicans were targeting the wide array of health care services provided by Planned Parenthood for patients on Medicaid. The organization’s services include birth control, cancer screenings and testing and treatment for sexually transmitted infections or STIs.

“This is some kind of bizarre quest to just continue to, you know, punish Planned Parenthood,” said Sen. Tracy McCreery, a St. Louis Democrat. “But the reality is…it’s not punishing Planned Parenthood. What this is doing is, this is hurting our very own constituents.”

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.

Coleman said on the floor that the fact that the Missouri clinics no longer provide abortions was not enough. She pointed to the fact that Planned Parenthood affiliates still provide abortions in neighboring Kansas and Illinois.

“Dollars are fungible and that money that is not being used to support those clinics (in other states) is able to be money that they are spending on, many times, Missouri residents,” she said.

Senate Democrats took shifts late into Tuesday evening chewing up floor time to block the legislation. They spoke about the negative impact the bill could have on Medicaid and at times shifted to other topics such as gun control. They ultimately sat down early Wednesday morning, letting it come to a vote.

Democrats were able to remove a line from the bill that described facilities barred from receiving funding as “promoting eugenics as a means of limiting the procreation of such persons of such races, colors, or national origin, including, but not limited to, sterilization or the use of targeted abortions.”

Senate Minority Leader John Rizzo, an Independence Democrat, said in a statement to The Star that the legislation “does nothing that (Republicans) weren’t already doing and is more than likely unconstitutional.”

“They wasted an entire day in the senate passing legislation that they in effect already do,” Rizzo said, saying that Republicans were focused on the bill instead of legislation to keep rural hospitals open and a bill to keep the state’s health care system working.

Some in the Missouri Capitol view the bill 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.

Lawmakers in both parties fear that adding the anti-abortion language to the FRA could result in the entire bill being struck down in court.

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.

Tuesday’s hours-long debate also comes as a coalition of abortion rights groups are seeking to overturn the state’s abortion ban at the ballot box this year. The group is currently gathering signatures to place the measure on the ballot either in November or at an earlier election if called by Republican Gov. Mike Parson.

Sen. Lauren Arthur, a Kansas City Democrat, said in a statement that Missouri Republicans “have made it crystal clear that they are against any and all forms of reproductive healthcare.”

“We began debating this issue back in February, and after two months and another 11 hours on the floor last night we recognized that because Republican lawmakers are never going to change their mind on this issue, it will be up to voters to change the law at the ballot box this November,” she said.