Missouri Advocates Sue to Overturn More Than a Dozen Laws on Abortion

Just hours after voters passed a constitutional amendment aimed at protecting reproductive rights in Missouri — making it the first state to overturn a near-total ban on abortion — key backers of the Right to Reproductive Freedom Initiative filed a lawsuit in Kansas City seeking to effectuate the will of the voters.

“The voters of Missouri have said, ‘enough,’” reads the suit filed by Comprehensive Health of Planned Parenthood Great Plains and Planned Parenthood Great Rivers, the state’s Planned Parenthood affiliates. “This amendment returns reproductive health care decisions back to where they belong: with individuals and their trusted health care providers, not Missouri politicians.”

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While the measure, known as Amendment 3, provides a seemingly expansive view of reproductive rights, including abortion, the groups must take legal action to give it force and effect. In other words, the amendment will not do the job on its own; instead, lawsuits will be necessary to challenge statutes — including the abortion ban — that are currently on the books. The Wednesday lawsuit takes on more than a dozen state laws, which advocates argue now conflict with the state constitution’s explicit protection for reproductive rights. The amendment takes effect December 5; the providers are asking the courts to take action now so that abortion services can be restored promptly thereafter.

The office of Attorney General Andrew Bailey, which would be tasked with defending the state’s existing abortion laws in court, did not immediately respond to a request for comment.

During a Wednesday afternoon press conference, representatives of the state’s two Planned Parenthood affiliates, along with the American Civil Liberties Union of Missouri, said they are challenging laws that pose an immediate barrier to providing abortion and that three clinics in the state — in Kansas City, St. Louis, and Columbia, home to the University of Missouri’s flagship campus — will be ready to reopen their doors in a month. “If able, we plan to immediately restart services,” said Richard Muniz, Planned Parenthood Great Rivers interim president and CEO.

Along with the state’s abortion ban, the advocates are challenging several other laws that impose gestational age limits on abortion — including one that bars abortion after eight weeks of pregnancy, well before many people know they’re pregnant, and laws that prohibit abortion after 14, 18, and 20 weeks.

Amendment 3 allows for some regulation of abortion after the point of fetal viability — that is, the point at which a fetus can survive outside the womb absent “extraordinary” medical efforts. In a seeming effort to constrict the state’s Republican supermajority legislature from penning any one unilateral standard, the measure also tasks health care providers with defining viability on a case-by-case basis. Whether that works to stave off legislative attacks remains to be seen — and would likely prompt further litigation.

The advocates are also challenging state laws that place onerous and medically unnecessary restrictions on abortion providers — what are commonly known as targeted restrictions on abortion providers, or TRAP, laws. These are laws passed under the guise of ensuring patient health and safety but are imposed only on abortion providers and not on doctors or medical facilities providing any other kind of health care. This includes provisions that impose a hospital-admitting privileges requirement for abortion providers; the catch-22 is that admitting privileges are routinely only extended to doctors who regularly admit a certain number of patients to the hospital, but because abortion is incredibly safe, abortion providers often cannot meet such a requirement.

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The Missouri advocates are also challenging a 72-hour mandatory waiting period, which is purportedly meant to give patients time to reflect on their choices. Practically speaking, the provision does no more than to delay care and increase costs for patients attempting to access abortion by necessitating additional travel, time off work, and, often, child care.

In all, the current lawsuit targets 16 statutes that providers say now directly conflict with the state’s constitution. “There can be no doubt that the … bans, restrictions, and regulations, challenged herein, are presumptively unconstitutional because they deny, interfere with, delay, and otherwise restrict abortion access,” reads the lawsuit. “They also discriminate against pregnant Missourians who choose abortion and penalize and discriminate against abortion providers who assist Missourians exercising this fundamental right.”

Notably absent from the lawsuit, however, are at least two additional onerous restrictions: a ban on Medicaid funding for abortion and a statute that requires parental notification for minors seeking care. “We are moving as swiftly as possible to restart abortion services here in Missouri when Amendment 3 takes effect,” Muniz explained during the press conference. So the lawsuit asks the courts to block the “most immediate and direct barriers on abortion access for both our patients and our providers.” Still, he said, “to be clear, this is only the first step to fully implementing the protections of Amendment 3, it’s certainly not the last step.”

But the failure to challenge those restrictions, and to deem them not a pressing matter, leaves some of the state’s most vulnerable patients subject to likely unconstitutional mandates for the foreseeable future.

“Who decided which barriers are most immediate, and how?” asked Stephanie Kraft Sheley, a lawyer and the project director and founder of Right By You, which helps young Missourians navigate reproductive health care options in the state. “For people without a lot of money, the most immediate barrier is often inability to pay for their care.” Inability to cover the cost of care is the “most common reason” people seeking abortion care reach out to Right By You, she said.

“For teens, the most immediate barrier is often severe restrictions on their autonomy,” along with laws that block others from helping them to access that care, she said. “Those are immediate barriers worthy of addressing on day one.”