Missouri
Ranking: 8
- The legislature has found that the life of each human being begins at conception.
- As applied to its abortion-related laws, Missouri maintains a narrow definition of “medical emergency”: a medical emergency is deemed to exist only in situations where a woman’s life or a “major bodily function” is at risk.
- Missouri prohibits partial-birth abortion.
- Missouri has a post-viability abortion ban that allows an abortion only when the life of the mother is endangered by a physical disorder, physical illness, or physical injury, including a life-endangering physical condition caused by or arising from the pregnancy itself, or when continuation of pregnancy will create a serious risk of substantial and irreversible physical impairment of a major bodily function of the pregnant woman. The law also requires determination of gestational age according to specified standards, includes reporting requirements, and requires a second physician to concur that an abortion is medically necessary.
- Twenty-four hours prior to abortion, a woman must be advised of the risks of abortion, given information about the development of her unborn child, and provided information on resources available to assist her in bringing her child to term. The law also requires that she be informed that abortion ends the “life of a separate, unique, living human being.”
- Abortion providers must offer an ultrasound to every woman seeking an abortion.
- Women seeking abortions at or over 22-weeks gestation must be counseled on fetal pain.
- Abortion clinics must provide a woman with confidential access to a telephone and list of protective resources if she indicates that she is being coerced by a third party into seeking an abortion.
- A physician may not perform an abortion on an unemancipated minor under the age of 18 without the informed, written consent of one parent or a court order. Further, only a parent or guardian can transport a minor across state lines for an abortion. A physician who is alleged to have violated this law may provide evidence of a medical emergency as an affirmative defense.
- Missouri requires that abortion clinics meet stringent ambulatory surgical center standards.
- Only physicians licensed by the state, practicing in Missouri, and having surgical privileges at a hospital that offers obstetrical or gynecological care may perform abortions. The Eighth Circuit Court of Appeals has upheld this requirement.
- A physician performing abortions must have admitting privileges at a hospital within a 30-mile radius of the facility where the abortion is performed.
- Missouri law provides that no person shall perform or induce a “medical abortion” unless such person has proof of medical malpractice insurance with coverage amounts of at least $500,000.
- The state has an enforceable abortion reporting law, but does not require the reporting of information to the Centers for Disease Control (CDC). The measure pertains to both surgical and nonsurgical abortions and requires abortion providers to report short-term complications.
- Missouri follows the federal standard for Medicaid funding for abortions, only permitting the use of federal or state matching Medicaid funds for abortions necessary to preserve the life of the woman or when the pregnancy is the result of rape or incest.
- Missouri law provides that it is unlawful for any public funds to be expended for the purpose of performing or assisting an abortion not necessary to save the life of the mother or for the purpose of encouraging or counseling a woman to have an abortion not necessary to save her life.
- The state has an extensive list of additional limitations on abortion funding, including the following: public facilities may not be used for performing, assisting in, or counseling a woman on abortion unless it is necessary to preserve the woman’s life; a state employee may not participate in an abortion; no school district or charter school or personnel or agents of the schools may provide abortion services or permit instruction by providers of abortion services; family planning services may not include abortions unless it is certified by a physician that the life of the mother is in danger; “Missouri Alternatives to Abortions Services Program” funding may not be granted to organizations or affiliates of organizations that perform or induce, assist in the performance or induction of, or refer for abortions; research grants may not be used in research projects that involve abortion services, human cloning, or prohibited human research, and cannot share costs with another prohibited study; and no money from the legal expense fund may be used to defend abortion.
- Private health insurance policies are prohibited from including coverage for abortion unless an abortion is necessary to preserve the life of the woman or an optional rider is purchased. Missouri also prohibits abortion coverage for state employees except in cases of life endangerment. Further, Missouri protects individual and group insurance consumers from paying for insurance coverage that violates their moral or religious beliefs.
- State health insurance for uninsured children cannot be used to encourage, counsel, or refer for abortions, with exceptions for life endangerment or in cases of rape or incest.
- Insurance companies participating in the state insurance Exchanges established pursuant to the federal healthcare law (required to be operational by 2014) cannot offer policies that provide abortion coverage within the Exchanges, expect in cases of life endangerment.
- Missouri has appropriated federal and state funds for women “at or below 200 percent of the Federal Poverty Level” to be used to encourage women to carry their pregnancies to term, to pay for adoption expenses, and/or to assist with caring for dependent children.
- Missouri provides direct taxpayer funding to pregnancy care centers and prohibits organizations that receive this funding from using those funds to provide abortion counseling or to make referrals for abortion.
- Missouri also provides tax credits for donations to pregnancy care centers that do not perform or refer women for abortions. The state is authorized to issue tax credits for six years, worth half the value of donations between $100 and $50,000.
- Health plans that provide prescription coverage must also cover contraception, but certain exceptions apply.
- Under Missouri law, the killing of an unborn child at any stage of development is defined as a form of homicide.
- The state allows a wrongful death (civil) action when an unborn child at any stage of development is killed through a negligent or criminal act.
- Missouri has enacted AUL’s “Pregnant Woman’s Protection Act,” which provides an affirmative defense to women who use force to protect their unborn children from criminal assaults.
- The state has created a specific affirmative duty of physicians to provide medical care and treatment to infants born alive at any stage of development.
- Missouri has a “Baby Moses” law, establishing a safe haven for mothers to legally leave their infants at designated places and ensuring that the infants receive appropriate care and protection.
- The state funds drug treatment programs for pregnant women and newborns.
- In November 2006, Missouri voters approved a ballot initiative amending the state constitution to allow cloning-for-biomedical research (while banning cloning-to-produce-children) and destructive embryo research. This constitutional amendment may mean that the state’s ban on public funding relates only to cloning-to -produce-children.
- The state’s prohibition on fetal experimentation applies only to a fetus aborted alive.
- Missouri has created a program funding the establishment of umbilical cord blood banks. The state Department of Health and Senior Services is to post resources regarding umbilical cord blood on its website including information on the potential value and uses of cord blood. The state authorizes a licensed physician giving care to a pregnant woman to provide information about this website.
- Missouri maintains no laws regarding human egg harvesting or assisted reproductive technologies.
- In Missouri, assisted suicide constitutes manslaughter.
- A physician, nurse, midwife, or hospital is not required to admit or treat a woman for the purpose of abortion if such admission or treatment is contrary to religious, moral, or ethical beliefs or established policy. Protection is also provided to medical and nursing students.
- A law requiring insurance coverage for obstetrical and gynecological care provides: “Nothing in this chapter shall be construed to require a health carrier to perform, induce, pay for, reimburse, guarantee, arrange, provide any resources for, or refer a patient for an abortion.”
- Missouri currently provides no protection for the rights of healthcare providers who conscientiously object to participation in human cloning, destructive embryo research, or other forms of immoral medical research.
- In November, Missouri voters approved a state constitutional amendment prohibiting the establishment, creation, or operation of a health insurance exchange unless it is created by a legislative act, a ballot initiative, or veto referendum.
- Missouri extended an existing prohibition on the allocation of “Missouri Alternatives to Abortion Services Program” funds to abortion providers.
- The legislature overrode Governor Jay Nixon’s veto of legislation which will protect individual and group insurance consumers from paying for insurance coverage that violates their moral or religious beliefs.
- Missouri considered measures related to abortion funding, insurance coverage of abortion, and support for pregnancy care centers including direct funding as well as a measure protecting the religious mission of the centers.
- The state also considered measures banning sex-selective and race-based abortions, requiring a reflection period before abortion, regulating abortion clinics and providers (including a measure related to an abortion provider’s liability in civil lawsuits or for violations of state abortion-related laws), and enhancing its abortion reporting requirements.
- The state also considered a resolution opposing the U.S. Department of Health and Human Services (HHS) mandate that nearly all insurance plans fully cover “all FDA approved contraceptives” (which includes the abortion-inducing drug ella).
- While the majority of measures considered in Missouri affirmed life, the state also considered a measure requiring emergency rooms to provide sexual assault victims with information about and/or access to “emergency contraception.”
- In regard to bioethics, the state considered a measure proposing an amendment for consideration in November 2012 that would have prohibited the funding of human cloning for all purposes. Missouri also considered legislation related to insurance coverage of assisted reproductive technologies.
- Missouri considered measures relating to advance planning documents, pain management, and palliative care.
- Missouri considered comprehensive conscience protection and legislation to include or expand exemptions for religious-based objections to the state’s existing “contraceptive” (insurance) mandate.
- Conversely, the state considered legislation forcing pharmacists and/or pharmacies to stock and dispense “emergency contraception.”
- Defunding the Abortion Industry and Advancing Women’s Health Act
- Women’s Health Defense Act
- Prenatal Nondiscrimination Act
- Abortion-Inducing Drugs Safety Act
- Child Protection Act
- Ban on Abortions Performed for Reasons of Sex Selection
- Joint Resolution Commending Pregnancy Centers
- Law criminalizing nonfatal assaults on the unborn
- Assisted Reproductive Technologies Disclosure and Risk Reduction Act
- Healthcare Freedom of Conscience Act
