Hey Missouri? Can We Talk About What’s Going On With You and Abortion?

You’re off your tether, Missouri, and you’re lumbering around knocking over telephone poles and stripping pregnant people of their human rights.

Gov. Eric Greitens (R) meets with Vice President Mike Pence at the White House on January 28. Wikimedia Commons

Hello, Missouri? Do you mind if I call you Missouri?

It just has a nicer ring than “Missouri State Legislature,” though of course there are plenty of people inside the state working against anti-choice machinations. I’m just going to call you Missouri for short, though. You don’t mind, do you?

I thought it might be nice for us to sit down and catch up. It’s been two years since we last had a chat: In 2015, I wrote you an open letter about your herculean efforts to regulate the last clinic in your state out of existence.

Fortunately, despite your best efforts, clinic access in Missouri is actually getting better. Prior to September of this year, there was only one standalone abortion clinic—the same one you tried for years to shut down. Now, as Rewire reported back in September, Planned Parenthood has opened a second. And according to this report from Christina Cauterucci at Slate, the state might soon have five clinics.

Five! That’s good news for pregnant people that live inside you, Missouri.

But you haven’t given up trying to stick it to them.

During the 2017 regular legislative session, you tried to pass more than 20 bills. All of them failed. And then in June, your Republican governor, Eric Greitens, called a second special session—to focus on cracking down on abortion. It was a Hail Mary attempt to ram through ten more bills restricting abortion access.

All of them failed except one, SB 5—and that one is already in litigation.

SB 5 is an omnibus Frankenbill—pieces of different bills grafted together—that Gov. Greitens signed into law on July 26. It contains pieces of bills that the legislature couldn’t get passed during the regular session.

One provision of SB 5, which gives your attorney general “concurrent original jurisdiction”(legalese for “allows the AG to open independent investigations into alleged clinic violations”) comes from two failed regular session attempts to pass the same policy—one in the house and one in the senate. That section was rammed through out of concerns that local governments—in St. Louis, for example—are run by Democrats and are too progressive, according to GOVERNING. “The prosecuting attorney in St. Louis is a pro-choice Democrat, so we just wanted another set of eyes there,” Andrew Koenig (R-Manchester), the state senator who sponsored SB 5, is reported to have said.

It takes a red-blooded Republican to harass clinics out of existence, I reckon.

Another section of SB 5, meanwhile, comes from a failed regular session bill—HB 989—that purported to prohibit cities or towns from declaring themselves “sanctuaries” for abortion. Some readers may be asking: What the hell is an abortion sanctuary?

Great question. First and foremost, the language is probably a scare tactic that Republicans are using to capitalize on the pervasive, racist, and unwarranted fear of undocumented immigrants, what with cities around the country refusing to kowtow to President Donald Trump by announcing that they would become “sanctuaries” for undocumented immigrants to live without worrying, at least in theory, that any interaction with a public official or agency would result in deportation. The “abortion sanctuary” term is tacky at best, but tackiness is no stranger to you, is it Missouri? (Remember the “All Lives Matter” Act, which your legislature tried to pass in 2016? HB 1794? Exactly. Tacky.)

But aside from that, what is an abortion sanctuary city? Anyone’s guess is as good as mine, although St. Louis is apparently one. This actually gets a little bit weird: St. Louis passed an ordinance in February that prohibits discrimination on the basis of a person’s reproductive health-care decisions. So, for example, an employer couldn’t refuse to hire you because you use birth control, have had an abortion, or are pregnant. Seems pretty straightforward.

Not to Gov. Greitens, though. Apparently, by calling the special session, he intended to make do on his promise at an anti-abortion rally back in March to stop those “crazy liberals and their allies at organizations like NARAL that are trying to create an abortion sanctuary city right here in the state of Missouri.”

Why your governor has his knickers in a twist about St. Louis’ ordinance is anybody’s guess. The “no country for old abortion” provision of SB 5 really has nothing to do with the city’s ordinance.  It bans local governments from enacting laws that would force a person to participate in an abortion if they didn’t want to, or force a property owner to sell or lease property to a clinic, or interfere with the operations or free speech rights of “crisis pregnancy centers.”

As St. Louis Alderwoman Megan Greene told Missourinet before SB 5 was signed into law, the bill doesn’t even address St. Louis’ nondiscrimination ordinance.

Is there something in the statehouse water? Because Republicans there aren’t make any sense.

Another section of SB 5 requires abortion providers to create a “complication plan” for medical abortions and to get that plan approved by the Missouri Department of Health and Human Services (DHHS). It’s a TRAP law (that’s Targeted Regulation of Abortion Provider, for those who don’t know) that the house tried to pass on its own, to no avail.

In the wake of SB 5’s passage, DHHS issued a memo on October 2 stating that it would be filing emergency rules setting out the standards for complication plans this week, according to St. Louis Public Radio. Doctors who provide medical abortions would be required to contract with an OB/GYN to treat any complications that arise. If that sounds sort of like an admitting privileges law—the kind that the Supreme Court struck down in Whole Woman’s Health v. Hellerstedt because Texas provided no evidence that the law would actually improve women’s health and safety—that’s because it kind of is. And that’s why I’m pretty sure once the DHHS issues standards for these complication plans, Planned Parenthood or another group will file a lawsuit challenging them. (Planned Parenthood has not done so yet, likely because the lawsuit is not “ripe”—in other words, there are no standards yet with which clinics have to comply, so clinics have nothing to sue about. As soon as those standards are issued, however, the lawsuit will become “ripe” and Planned Parenthood will be able to file a lawsuit challenging them.)

And then there’s the provision that has landed SB 5 in court: the “same physician” requirement, which you added to your “informed consent” requirements. This is where it gets truly ridiculous.

You already have a pretty extensive regulatory framework about consent, Missouri. Pregnant people must go to a clinic to receive state-mandated information in a private setting both in writing and orally. And pregnant people have to do all of this 72 hours before the abortion. This means that someone who, say, lives four hours away from a clinic might have to make at least two eight-hour trips in a week to access care. It’s a pain in the ass, is what I’m saying, Missouri.

And now, in addition to all of that, SB 5 requires that the state-mandated information be given by the same physician who is going to perform the abortion. It used to be that the information could be provide by a “qualified professional.” But that wasn’t enough. Now you want to stretch already thinly stretched abortion doctors even further, by forcing them to take on added counseling responsibilities?

What is the health benefit of that, Missouri? Oh, there is none and you know it.

And I’d be willing to bet that your little law doesn’t pass the Whole Woman’s Health v. Hellerstedt smell test, which requires a law that is touted as being for the benefit of women’s health and safety to actually be for the benefit of women’s health. States just can’t claim it is and rest smugly on their laurels. The resident U.S. Supreme Court data nerd—Justice Stephen Breyer—isn’t having any of that. States have to prove it.

And I don’t think you can prove it, Missouri. And neither does Comprehensive Health of Planned Parenthood Great Plains, which is why it sued you in the first place. Sure, the district court judge Monday said that the waiting period is constitutional and that the same-physician requirement is constitutional. Jackson County Circuit Court Judge S. Margene Burnett said that the scarcity of abortion doctors isn’t your fault, Missouri, and that the law doesn’t impose an undue burden on the right to an abortion. Really, Marge?

Pfft. We’ll just have to see what happens when the Supreme Court gets their hands on this one. First, the scarcity of abortion doctors actually is your fault, Missouri: You tried to pass over a hundred bills regulating the one clinic out of existence. And now that you have successfully whittled down the number of abortion doctors in the state—either because they have no practice or because they fear criminalization—suddenly it’s not your fault?

That’s not how this works. At least, that’s certainly not how it should work.

Aside from your looming court battles, let’s chat about some of the other nonsense you tried to pull this year, Missouri.

You tried four times to make 20-week abortion bans happen. Like so much “fetch,” it didn’t. You also took several stabs at trying to make personhood happen. That didn’t happen either. You tried to ban abortion outright (HB 1177) and also tried to ban it at six weeks (SB 408), which is when a heartbeat can be detected. Neither of those laws is constitutional, Missouri. You know better.

You introduced several bills that regulated or banned fetal tissue donationseveral bills dedicated to making it more difficult for pregnant teens to obtain abortion care, and a couple bills that criminalize prenatal drug and alcohol use, virtually ensuring that pregnant people who happen to be addicted to drugs won’t seek care out of fear of imprisonment.

And you also tried to pass several bills that would let CPCs continue to prey on pregnant people, by prohibiting local governments from regulating them.

Plus, there were a couple of bills that defy logic and categorization: laws that seem designed just to piss me off. Yes, me, specifically. A bill requiring that the state museum include an abortion exhibit? And that the abortion exhibit must be near the exhibit on slavery? (This, of course, was introduced by the same guy who introduced the All Lives Matter Act personhood bill.)

You’re out of control, Missouri. More than 35 bills and you managed only to pass one, which is already in court.

You’re like one of those unmoored oversized floats you see at the Thanksgiving Day parade in New York City—you know the one that gets loose because it was manned by a dude who accidentally put too much whisky in his coffee?

You’re off your tether, Missouri, and you’re lumbering around knocking over telephone poles and stripping pregnant people of their human rights.

And let’s face it, you’re probably going to get your ass handed to you by Planned Parenthood, and then your taxpayers are going to have to pay Planned Parenthood’s attorneys’ fees, and it seems that money could be better spent on—I don’t know—expanding Medicaid?

Look, Missouri, I know it’s not the entire state that has been making some questionable decisions. There are plenty of lawmakers and grassroots activists working hard to make life better for pregnant people in Missouri. Many Missourians love their state and just want to be healthy and to prosper. That doesn’t seem to be Republicans’ bag, though.

So I don’t know what to tell you, Missouri.

You’re the “show me” state, right? So show me some thing good. Show me that people in Missouri can rest assured that they will have access to affordable health care, including abortion. Maybe show Republicans the door. Otherwise you’ll remain—as a friend from Missouri once told me—the “show me the way out” state. And you don’t want that, do you?

Of course not.

Good walk and talk Missouri. Let’s not have this conversation again. It’s exhausting.