All eyes have been on the healthcare reform negotiations in
Washington, D.C. for months and it is easy to see why. The Stupak Amendment to
healthcare reform legislation in the House and the Nelson "compromise" contained
in the healthcare reform legislation passed out of the Senate demonstrate how healthcare reform will likely result in women having  fewer option for reproductive healthcare coverage than they currently do. 

While healthcare reform has been quite a process
to watch and participate in, action at the state level is heating up.  Many state
legislative sessions are opening this month, and advocates will have to balance ongoing federal policy negotiations with politics a little closer to
home.

In my home state of Missouri, where many legislators indulge
in annual attacks of access to reproductive healthcare, keeping a sharp eye
trained on state legislation is a required skill for reproductive justice
activists…and we’re still dealing with the ramifications of anti-choice
legislation passed in previous sessions.

In 2008, Missouri elected Jay Nixon, a pro-choice Democratic governor but the House and Senate remain under Republican control. That often
translates into a hostile environment in Jefferson City where reproductive
healthcare advocates balance beating back anti-choice legislation and
amendments with trying to right policy wrongs passed in previous sessions.

One
key wrong that hinders the cause of reproductive justice in Missouri is the Omnibus Sex MIS-Education and Abortion Bill
that was passed in 2007. Among other things, this bill changed the requirement that public schools must provide
medically accurate and complete information about contraception in sex education
classes and allows schools to eliminate information about
contraception or to focus only on contraceptive failure rates. The law prohibits materials to be used and sex educators from teaching in public schools if they are connected
to an entity that refers for or provides abortion, and that includes most
hospitals and health clinics. In short, this law requires educators to
not educate their students.

This anti-knowledge
mandate couldn’t have come at a worse time for many Missouri communities. St.
Louis city leads the nation in rates of two common sexually transmitted
infections (STI), Chlamydia and gonorrhea. Even as reproductive justice activists
address the federal funding restrictions that have helped fuel the lack of
focus on prevention programs, Missouri’s anti-education sex education law
remains a hurdle between proven prevention and daunting STI rates in many
communities. As a result, prevention programs struggle for funding and are
joined by educators in the struggle against restrictions while legislators
pander to anti-choice forces dedicated to keeping restrictions in place despite
the realities on the ground.

During the 2009
Missouri legislative session, lawmakers spent hours debating an Anti-Freedom
of Choice Act resolution that denounced a piece of federal legislation that
wasn’t introduced and thus didn’t need to be discussed, denounced or debated on
a state level. Anti-choice lawmakers introduced bills that attempted to
create a new crime of "coercing an abortion," to protect
pharmacies from recriminations if a pharmacist refuses to fill a prescription
for contraception and to criminalize a pregnant woman who goes to term
before she is able to overcome addiction to drugs and/or alcohol.

During the same
session, lawmakers passed on an
opportunity to support prevention policies like allowing trained sex
education professionals to be invited back into public schools and to require
voluntary sex education courses to include information on both abstinence and
the benefits of contraception. Leaders in the Missouri House and Senate passed
on promoting treatment through expedited partner therapy that would allow
physicians to treat a patient’s partner without having an existing doctor/patient
relationship when that patient is diagnosed with Chlamydia or gonorrhea and on requiring
insurance companies to provide coverage for HPV screening. Those same leaders
opted not to pursue legislation protecting a patient’s right to get a
prescription filled without discrimination or delay and ensuring that victims
of sexual assault who present at an emergency room are provided with
information about and access to emergency birth control such as Plan B.

2010 provides an
opportunity for the Missouri state legislature to get it right and focus on the
realities on the ground rather than the dogma being shouted from the often
vocal but rarely reasonable anti-choice mob. Despite those realities facing
many Missouri communities, anti-choicers have already pre-filed
legislative attacks on reproductive choice.

So, reproductive justice
advocates are gearing up to defend against any anti-choice legislation this session while lobbying for the prevention programs our
communities desperately need with the hope that funding will also come through
and with the certainty that knowledge is power and policy should support that. As
the federal government moves forward with health care reform in 2010, activists
in many states are going to have to multi-task to make sure that the full range
of reproductive health care services and comprehensive sex education are not
left behind by federal healthcare reform or by state policies designed to
prevent knowledge while doing little to promote health in local communities.