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Restrictions on Low-Income Women's Access to Abortion

Missouri prohibits public funding for abortion for women eligible for state medical assistance for general health care unless the physician certifies that the woman's life is endangered by a physical disorder, physical injury, or physical illness, including a life-endangering physical condition caused by or arising from the pregnancy itself, or the pregnancy is the result of rape or incest.  Mo. Dep't of Soc. Servs., Mo. HealthNet Division, Mo. Medicaid Provider Manual: Physician, § 13.40.I (Sept. 1, 1998) at; Mo. Dep't of Soc. Servs., Mo. HealthNet Division, Certification of Medical Necessity for Abortion (Aug. 1999), at

Invalid and enjoined statutes prohibit public funds for abortion unless the procedure is necessary to preserve the woman's life.  Mo. Ann. Stat. §§ 188.205 (Enacted 1986), 208.152(1)(11) (Original Statute Enacted 1967; Relevant Provision Enacted 1973; Last Amended 1981; Renumbered 2005).

A court held that this restriction conflicts with federal law prohibiting participating states from excluding abortion from the Medicaid program in cases of rape or incest, as well as life endangerment.  The court declared that the state may not enforce the statute, so long as it accepts federal Medicaid funds.  Stangler v. Shalala, No. 94-4221-CV-C-5 (W.D. Mo. Dec. 28, 1994).

The Missouri legislature enacted a bill that prohibits any funds distributed through the Department of Health for the Division of Maternal, Child and Family Health from being used to provide or refer for abortion services; specifically, organizations that receive state family-planning funds are prohibited from providing, assisting, or referring a patient for abortion services.  H.B. 10, 94th Gen. Assem., Reg. Sess. (Mo. 2007) (Enacted 2007).  To the extent that this law prohibits funding for abortion in cases of life endangerment, rape, or incest, it is in conflict with federal law.

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