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Inside Missouri's push to ban out-of-state abortions

The outside of the Planned Parenthood Reproductive Health Services Center is seen in St. Louis, Missouri, May 30, 2019, the last location in the state performing abortions. - A US court weighed the fate of the last abortion clinic in Missouri on May 30, with the state hours away from becoming the first in 45 years to no longer offer the procedure amid a nationwide push to curtail access to abortion. (Photo by SAUL LOEB / AFP)        (Photo credit should read SAUL LOEB/AFP via Getty Images)
The outside of the Planned Parenthood Reproductive Health Services Center is seen in St. Louis, Missouri, May 30, 2019, the last location in the state performing abortions. - A US court weighed the fate of the last abortion clinic in Missouri on May 30, with the state hours away from becoming the first in 45 years to no longer offer the procedure amid a nationwide push to curtail access to abortion. (Photo by SAUL LOEB / AFP) (Photo credit should read SAUL LOEB/AFP via Getty Images)

In Missouri, lawmakers are trying to deter women from going out of state to receive an abortion.

How? By considering legislation that would allowing private citizens to sue anyone who helps a woman cross state lines for the procedure.

“Even a decade ago, some of what we now believe and are operating under in terms of abortion laws and restrictions were thought to be so extreme they would never pass,” Dr. Colleen McNicholas, chief medical officer of Planned Parenthood of the St. Louis Region and Southwest Missouri, says.

Another proposal could limit treatments for non-viable, life-threatening pregnancies.

“We’ve really started to travel into some dangerous territory where legislators are not ashamed to show that they don’t understand the science,” McNicholas adds.

Today, On Point: We take a close look at Missouri’s new abortion proposals, and whether other states could follow.


Tessa Weinberg, reporter at the Missouri Independent. She covers education, health care and the legislature. Author of the article Planned Parenthood sues Missouri social services agency over restricted Medicaid funds. (@Tessa_Weinberg)

Dr. Colleen McNicholas, chief medical officer of Planned Parenthood of the St. Louis Region and Southwest Missouri. (@docmcnick)

Mary Elizabeth Coleman, Republican state representative from Arnold, Missouri since 2018. She practices law at Thomas More Society, a national conservative not-for-profit law firm. (@meaccoleman)

Also Featured

Mary Ziegler, professor at Florida State University College of Law and a visiting professor of constitutional law at Harvard Law School. (@maryrziegler)

Rebecca Doe, who experienced an almost fatal ectopic pregnancy in 2009.

Transcript Highlights: Understanding Missouri’s Push To Ban Out-Of-State Abortions

MEGHNA CHAKRABARTI: 30 years ago, there were 29 abortion clinics in the state of Missouri. Today there is only one, and that one came close to shutting down in 2020.

NEWS BRIEF [Tape]: Just in the last hour ruling that the Planned Parenthood facility in St. Louis will remain open. That new information coming this morning as a state government administrator decided that the health department was wrong not to renew the license of this facility. The facility in St. Louis is the only place a woman could get an abortion in the entire state of Missouri.

CHAKRABARTI: Abortions are legal in Missouri, up to 22 weeks gestation, but that was almost reduced down to eight weeks back in 2019.

NEWS BRIEF [Tape]: Legislators in Missouri overwhelmingly passed a sweeping law Friday, placing new restrictions on doctors who perform abortions. The law bans the procedure after eight weeks of pregnancy, with no exceptions for rape or incest. Doctors could face up to 15 years in prison for performing an abortion.

CHAKRABARTI: The law was overturned in federal court. So abortions until 22 weeks remain legal in the state. Nevertheless, Missouri already has some of the most restrictive laws on abortion access in the country. There are few abortions performed in the state. Very few. In fact, according to the preliminary data from the Missouri Department of Health, last year that one remaining clinic in St. Louis provided only about 10 to 20 abortions per month. But meanwhile, right across the border in Illinois, thousands of Missouri residents are receiving abortion care. So this year, Missouri lawmakers are pushing to ban access to out-of-state abortions.

The Missouri proposal uses the same quote ‘bounty hunter strategy’ that was behind Texas’s landmark abortion restrictions passed last September. And it’s just one of a slate of proposals coming out of Missouri that provide a clear indication of the direction some states intend to move in, should Roe v. Wade be struck down at the Supreme Court. So this hour, we’re going to take a close look at what’s happening in Missouri. And joining us now is Tessa Weinberg. She’s with the Missouri Independent. She’s been covering this issue deeply. Tessa, welcome to On Point.

TESSA WEINBERG: Thanks so much for having me.

CHAKRABARTI: So first of all, let’s just briefly talk about the bills that are under consideration right now. Tell us a little bit more about the amendment that everyone’s focusing on regarding deterring, trying to deter women to seek out-of-state abortions in Missouri.

WEINBERG: Yeah. So this has been an amendment posed by Representative Mary Elizabeth Coleman, a Republican lawmaker from Arnold, Missouri. And like the intro stated, it states that it would be unlawful for an abortion to be performed or to even assist a Missourian from getting an abortion, regardless of where the abortion is ultimately performed. And you know, in Missouri, there are very few abortions happening in the state. We currently only have one remaining clinic, Planned Parenthood affiliate in St. Louis, where you can go seek an abortion. So I think it’s safe to say that many of the abortions that do occur for Missouri residents are happening across state lines.

Many residents will go to neighboring Kansas or Illinois in order to seek an abortion. Missouri also has different provisions that require you receive counseling ahead of getting your abortion, and you have to have a 72-hour waiting period. So there are various restrictions here in Missouri, which make it sometimes easier for people to just simply go out of state. And so the amendment really aims to try to tackle that.

Especially, I think, as we look ahead to maybe what will happen at a national level, what will happen with Roe v. Wade. And the bill also provides us examples of providing transportation to someone to access an abortion, or even if you’re hosting a website that a Missourian could access that would help facilitate them to get one. And it also would declare abortion inducing drugs as contraband as well.

CHAKRABARTI: So to be clear, this amendment would allow private citizens to essentially bring civil suits against people, you know, quote-unquote aiding and abetting a woman seeking an out-of-state abortion. But it’s not the state that would be bringing the lawsuit. But in that case, it’s exactly like the the Texas Senate Bill 8. Is that right?

WEINBERG: Yeah, it’s similar to Texas law where this would be, you know, enforcement through lawsuits, that would not be enforcement by the state or the state health department really making sure this law gets enforced. It would be through litigation.

CHAKRABARTI: OK, so we’re going to talk more about about that. Bill, a little bit later or the amendment, I should say a little bit later, and we’ll also hear from Representative Mary Elizabeth Coleman, who has sponsoring the amendment. But it’s just one of several proposals that the Missouri legislature is considering that right now. Tell us about about some of the others.

WEINBERG: Yeah. I would say, the proposals that have maybe gone further so far through the process this year in the legislature are part of a years-long effort by lawmakers to restrict public funds from going to abortion providers and their affiliates. And in Missouri, that really means Planned Parenthood, since that’s the last remaining facility and provider we have offering abortions right now. And that kind of follows from the Supreme Court here in Missouri had ruled and struck down language in a 2018 budget bill that tried to bar public funds from going to abortion providers.

They struck that down and described it as a naked attempt to legislate through a budget bill. So since then, lawmakers have continued to try to restrict funding. And we saw already so far this session, lawmakers passed a supplemental budget bill that not only restricted Medicaid reimbursements to Planned Parenthood. Basically, abortion providers and their affiliates. But it had kind of a new tactic of technically providing a line item of funding, but setting that line item at zero dollars. And that is kind of a new tactic that anti-abortion advocates said that they hoped would withstand a court challenge this time and their standalone bills that still try to restrict public funds through statute.

One of the top senators who chairs the Appropriations Committee said he hopes to, intends to put similar language within the fiscal year 2022 – 2023 budget bill. So those are on a broader scale than I think some of the long term efforts that we are seeing across the finish line in the session this year. And I’ll note to you that with the language included in the supplemental budget, Planned Parenthood has sued over that. The Department of Social Services here in Missouri oversees and no health net, which is Missouri’s Medicaid program, and Planned Parenthood affiliates in Missouri had already received notices letting them know that their claims for Medicaid reimbursement were not going to be processed.

The department pointed to that supplemental budget bill, saying, You know, because of the language in that bill, we don’t have appropriation authority. And so Planned Parenthood is suing over that, saying that they will be unlawfully withholding those funds and booting them from the Medicaid program.

CHAKRABARTI: Point well taken. So while a lot of the headlines have been focused on the bills that would seek to materially limit access to abortions. You’re saying that the long term, the bigger long term threat to the remain remaining abortion provider in Missouri might be through these funding issues. So we’ll come back to that in a second, Tessa.

But I just do want to dig in a little bit to some of the other bills because there’s been a lot of focus in Missouri on medication that’s used to provide abortions, especially early term abortion. So there’s one in particular, House Bill 2810, which would make it a Class A or B felony in Missouri to participate in the manufacture, sale or transfer of abortion inducing equipment or drugs. Now this bill is sponsored by state Rep. Brian Seitz, Republican of Branson. And earlier this month, Democratic State Rep Mark Ellebracht questioned Seitz about just how much he knew regarding the details of his bill.

MARK ELLEBRACHT [Tape]: Do you know the range of punishment for a Class B felony?

BRIAN SEITZ: No, I do not.

ELLEBRACHT: It’s a minimum of five years in prison, maximum of 15. Do you know the range of punishment for Class A felony?

SEITZ: No, I do not.

ELLEBRACHT: It’s a minimum of 10 years in prison to a maximum of 30 years in prison or life. So you’re talking severe penalties.

SEITZ: It’s a very serious issue, what we’re talking about. What I would consider the murder of an infant, an infant in the womb. And the possible harm and possibly even causes of death, if they’re using these drugs and these in an illegal manner, it could actually kill the woman. And I think that penalty is probably not even strict enough.

CHAKRABARTI: So then Democratic state Rep. Mark Ellebracht offered Republican state Rep. Brian Seitz a possible scenario. Would Seitz think it’s appropriate to sentence and say 18-year-old woman who brought an abortion inducing pill to her 18-year-old friend, who had just found out she was pregnant? But Seitz said he would not engage in hypotheticals.

ELLEBRACHT: There’s going to be a prosecutor in the state who’s going to have a woman who’s 10 weeks and one minute pregnant, who’s friend went and brought her abortion bills. And he’s going to have to decide whether or not to seek up to life in prison for that. I’m just making sure that’s what you want, because that’s what your bill does.

SEITZ: I don’t know that prosecutor, and I don’t know the circumstances of the case.

ELLEBRACHT: So what do you think would be a fair punishment for this lady? I’m going to call her a child because she’s 18. What’s a fair punishment for this child?

SEITZ: I think those that induce an abortion on another person in violation of any state or federal law ought to be held accountable for that activity.

ELLEBRACHT: How many years in prison?

SEITZ: I couldn’t say what the statute is there.

ELLEBRACHT: Well, you can. …

SEITZ: If I wanted to be a prosecutor, I would have ran for that. My son is an attorney. He could do that. But at this time, I am a quote politician. So I’ll let those with a different skill set, determine that.

CHAKRABARTI: That’s Republican State Representative Brian Seitz being questioned by Democratic state Rep. Mark Ellebracht in Missouri earlier this month. Tessa Weinberg, we have about a minute before we have to take the first break here. It does seem as if representative Seitz didn’t fully actually understand what he himself was proposing. We can talk about that later. But I wanted to know sort of what is the mood in Missouri right now regarding this raft of of legislation that lawmakers are considering? How are people responding to it?

WEINBERG: Yeah, I mean, on that bill in particular, it was brought up again this week in committee and lawmakers did vote it out of committee. But they did notably remove many of those provisions that were, I think, causing concern and uproar. And, for example, the provision regarding ectopic pregnancies, that was taken out. And so it does seem to be that there was, you know, early pushback on that proposal and that it’s since been revised. And so it kind of will remain to be seen once it gets brought to the full house, of how a majority of lawmakers feel.

Related Reading

Missouri Independent:Planned Parenthood sues Missouri social services agency over restricted Medicaid funds.” — “Planned Parenthood’s lawsuit alleges Missouri’s Department of Social Services unlawfully plans to restrict Medicaid payments.”

New York Times: “Anti-Abortion Groups Once Portrayed Women as Victims. That’s Changing.” — “With Roe v. Wade on thin ice, state legislatures are producing a wave of anti-abortion bills, some of them truly eye-popping.”

Washington Post: “Missouri lawmaker seeks to stop residents from obtaining abortions out of state” — “Abortion rights advocates say the measure is unconstitutional. But it could signal a new strategy by the antiabortion movement to extend influence beyond the conservative states poised to tighten restrictions if the Supreme Court overturns the landmark precedent protecting abortion rights.”

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