Missouri could make it harder to get out-of-state abortions

JEFFERSON CITY, Mo. -- First-of-its-kind Missouri legislation shows that anti-abortion lawmakers in Republican-led states aren't likely to stop at banning most abortions within their borders but also could try to make it harder to go out of state to end pregnancies.

A proposal could be debated in the Legislature as soon as next week seeks to make it illegal to "aid or abet" abortions outlawed in Missouri, even if they are performed in other states.

Like a Texas law passed last year, the bill puts enforcement in the hands of residents, who could file lawsuits against those they believe have violated it.

State Rep. Mary Elizabeth Coleman's bill is aimed at a key frustration for abortion foes: people crossing state lines to avoid restrictions. The bill also targets a network of 90-plus groups across the U.S. that have sprung up specifically to preserve access to abortion.

The proposal comes as the U.S. Supreme Court is expected to decide by June whether to overturn its 1973 Roe v. Wade decision legalizing abortion and GOP-led states rush to pass more restrictions in anticipation the landmark ruling could be tossed out.

"If the court does that, the ability to get an abortion will be on the line for everyone in America, and so we're at a crisis point," said Andrew Beck, senior staff attorney with the ACLU Reproductive Freedom Project. "The Missouri bill crystallizes that as extreme and dangerous as that crisis is, it's just the first step in politicians' effort to outlaw abortions for everyone."

Missouri lawmakers in 2019 passed a law banning almost all abortions if Roe v. Wade is overturned.

Under Coleman's measure, anything from driving women across state lines for abortions to internet providers allowing access to certain abortion-related websites would be outlawed. She said St. Louis-area billboards advertising easier-to-get abortions in neighboring Illinois would be banned, too.

"It's trying to evade the laws of the State of Missouri," said Coleman, a St. Louis-area Republican. "Abortion is a really brutal practice and Illinois has chosen not to, in any way, provide protections for the unborn and women, and so we're trying to do everything we can to make sure Missourians are protected."

For a clinic across the state line from St. Louis, 75% of the patients from September 2021 through February were from Missouri, according to the Planned Parenthood affiliate operating it.

In the Kansas City area, the two clinics performing abortions are on the Kansas side. Missouri residents have traditionally accounted for a large percentage of the abortions performed in Kansas -- 42% in 2020, the latest data available.

"We're taking it (Coleman's proposal) seriously because I think if we've learned anything from Missouri and also from what's happened in Texas, it's that laws that clearly violate an individual's constitutional rights, rights that have been recognized and protected for decades, are now going into effect and impacting whether people can get care," said Emily Wales, president and CEO of the Planned Parenthood affiliate operating one of those Kansas City clinics.

Coleman's proposal also would outlaw paying for a woman's abortion or helping them get insurance coverage to pay for the procedure.

The Missouri Abortion Fund provided financial assistance to 1,866 Missouri residents seeking abortions last year -- only two of them in Missouri. Its aid averaged $113, but Michele Landeau, its president, said it helped some people who were only $10 short of being able to pay for their procedures.

"It's already so difficult to obtain abortion in Missouri and in a lot of parts of the country, and we don't need additional threats to people's lives and people's livelihoods," Landeau said.

While some legal experts doubt Coleman's proposal is constitutional, they also worry that the Supreme Court might refuse to intervene to stop it -- just as it did with the Texas law.

"It's unclear to these states what they're going to be able to do, and so I think they're sort of throwing everything at the wall to see what sticks," said Mary Ziegler, a Florida State University law professor.

The Missouri proposal comes as other Republican-led states consider laws like Texas, with Idaho lawmakers passing a similar measure this week.

"While this is the first, it could kick off similar measures elsewhere as states look to adopt more and more outrageous legislation," said Elizabeth Nash, a policy expert for the abortion-rights supporting Guttmacher Institute.

John Seago, legislative director of Texas Right to Life, said women traveling to other states is "going to be a reality" if Roe v. Wade is overturned. Since Texas' six-week ban took effect last year, clinics in neighboring states have reported a sharp increase in the number of patients from that state.

"This is something that the pro-life movement has to come to terms with and figure out what really is the proper response," he said.

Abortion-rights advocates said regardless of what happens with such laws in the courts, they can create fear or confusion.

"We still get calls from Texas ... where they ask, 'Is it even legal for me to call you?'" said Zack Gingrich-Gaylord, spokesman for the abortion-rights group Trust Women, which operates clinics providing abortions in Wichita, Kansas, and Oklahoma City.