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Supreme Court strikes down abortion-clinic funding ban

The Missouri Supreme Court has struck down a portion of an appropriations bill that barred Medicaid funding for “any abortion facility” in Missouri after finding it violated a constitutional prohibition on multiple-subject bills.

On June 30, in a 6-1 ruling, the court sided with Planned Parenthood of the St. Louis Region and affirmed a St. Louis circuit judge’s earlier ruling that the funding ban in the fiscal year 2019 appropriations bill violates the state constitution. Judge Zel M. Fischer dissented.

The case stems from language in the Missouri Department of Social Services’ appropriations bill for fiscal year 2019, which barred funding for “any abortion facility.” As a result of the law, Planned Parenthood’s sole abortion provider in the state could not be reimbursed for even non-abortion health care it provides through Missouri’s Medicaid program, MO HealthNet.

Planned Parenthood challenged the provision, arguing it is impermissible to use an appropriations bill to amend substantive law because it is a violation of article III, section 23 of the Missouri Constitution. St. Louis Circuit Judge David L. Dowd agreed, ruling that portion of the law was unconstitutional. The state appealed.

Writing for the majority, Judge Paul C. Wilson said the central issue was whether there is a direct conflict between statutes requiring MO HealthNet to pay its authorized providers, including Planned Parenthood, for covered physicians’ and family-planning services provided to Medicaid-eligible individuals and the language in the provision barring funding.

If a direct conflict exists, the provision is invalid because the Missouri Constitution prohibits using an appropriation bill to amend a substantive law, Wilson said. The majority concluded there is such a conflict.

Wilson said the language in the provision at issue “is a naked attempt” to use the appropriations bill to both appropriate funds and amend general law.

“This is a clear and unmistakable violation of the proscription in article III, section 23 of the Missouri Constitution against bills with multiple subjects,” he said.

Fischer disagreed, saying he would hold that the law is valid because the Missouri Constitution allows for multiple subjects in the context of appropriations bills.

Chuck Hatfield of Stinson, who represented Planned Parenthood, said he is glad to see the court largely side with his client.

“I think it gives you some indication that the court is pretty unified on this issue, and I think this is how the system is supposed to work,” he said.

Hatfield said the ruling is important because lawmakers increasingly have tried to legislate using the appropriations process.

The court’s opinion also has attracted attention from court watchers for a footnote condemning the use of citations to State ex rel. Gaines v. Canada, a 1937 Missouri Supreme Court case that denied a Black man entry to the University of Missouri School of Law. The U.S. Supreme Court later reversed it.

Planned Parenthood cited the case, among others, in its briefs, and the Missouri Attorney General’s Office denounced the citation, Hatfield said.

“Because the rot of state-mandated racial segregation infests the entirety of this Court’s Gaines decision, it is repudiated in its entirety and, henceforth, should no longer be cited even for the most otherwise impeachable legal principles,” Wilson wrote.

Hatfield called it a rare move by the court.

“I don’t know that I’ve ever seen a ruling like that,” he said.

A spokeswoman for the Attorney General’s Office did not respond to a message seeking comment.

The case is Planned Parenthood of St. Louis Region et al. v. Department of Social Services, Division of Medical Services et al., SC98020

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