In Missouri, Advocates Remain on Red Alert

All eyes have been on the healthcare reform negotiations in Washington, D.C. for months and it is easy to see why. The Stupak Amendment to healthcare reform legislation in the House and the Nelson "compromise" contained in the healthcare reform legislation passed out of the Senate demonstrate how healthcare reform will likely result in women having  fewer option for reproductive healthcare coverage than they currently do. 

While healthcare reform has been quite a process to watch and participate in, action at the state level is heating up.  Many state legislative sessions are opening this month, and advocates will have to balance ongoing federal policy negotiations with politics a little closer to home.

In my home state of Missouri, where many legislators indulge in annual attacks of access to reproductive healthcare, keeping a sharp eye trained on state legislation is a required skill for reproductive justice activists...and we're still dealing with the ramifications of anti-choice legislation passed in previous sessions.

In 2008, Missouri elected Jay Nixon, a pro-choice Democratic governor but the House and Senate remain under Republican control. That often translates into a hostile environment in Jefferson City where reproductive healthcare advocates balance beating back anti-choice legislation and amendments with trying to right policy wrongs passed in previous sessions.

One key wrong that hinders the cause of reproductive justice in Missouri is the Omnibus Sex MIS-Education and Abortion Bill that was passed in 2007. Among other things, this bill changed the requirement that public schools must provide medically accurate and complete information about contraception in sex education classes and allows schools to eliminate information about contraception or to focus only on contraceptive failure rates. The law prohibits materials to be used and sex educators from teaching in public schools if they are connected to an entity that refers for or provides abortion, and that includes most hospitals and health clinics. In short, this law requires educators to not educate their students.

This anti-knowledge mandate couldn't have come at a worse time for many Missouri communities. St. Louis city leads the nation in rates of two common sexually transmitted infections (STI), Chlamydia and gonorrhea. Even as reproductive justice activists address the federal funding restrictions that have helped fuel the lack of focus on prevention programs, Missouri's anti-education sex education law remains a hurdle between proven prevention and daunting STI rates in many communities. As a result, prevention programs struggle for funding and are joined by educators in the struggle against restrictions while legislators pander to anti-choice forces dedicated to keeping restrictions in place despite the realities on the ground.

During the 2009 Missouri legislative session, lawmakers spent hours debating an Anti-Freedom of Choice Act resolution that denounced a piece of federal legislation that wasn't introduced and thus didn't need to be discussed, denounced or debated on a state level. Anti-choice lawmakers introduced bills that attempted to create a new crime of "coercing an abortion," to protect pharmacies from recriminations if a pharmacist refuses to fill a prescription for contraception and to criminalize a pregnant woman who goes to term before she is able to overcome addiction to drugs and/or alcohol.

During the same session, lawmakers passed on an opportunity to support prevention policies like allowing trained sex education professionals to be invited back into public schools and to require voluntary sex education courses to include information on both abstinence and the benefits of contraception. Leaders in the Missouri House and Senate passed on promoting treatment through expedited partner therapy that would allow physicians to treat a patient's partner without having an existing doctor/patient relationship when that patient is diagnosed with Chlamydia or gonorrhea and on requiring insurance companies to provide coverage for HPV screening. Those same leaders opted not to pursue legislation protecting a patient's right to get a prescription filled without discrimination or delay and ensuring that victims of sexual assault who present at an emergency room are provided with information about and access to emergency birth control such as Plan B.

2010 provides an opportunity for the Missouri state legislature to get it right and focus on the realities on the ground rather than the dogma being shouted from the often vocal but rarely reasonable anti-choice mob. Despite those realities facing many Missouri communities, anti-choicers have already pre-filed legislative attacks on reproductive choice.

So, reproductive justice advocates are gearing up to defend against any anti-choice legislation this session while lobbying for the prevention programs our communities desperately need with the hope that funding will also come through and with the certainty that knowledge is power and policy should support that. As the federal government moves forward with health care reform in 2010, activists in many states are going to have to multi-task to make sure that the full range of reproductive health care services and comprehensive sex education are not left behind by federal healthcare reform or by state policies designed to prevent knowledge while doing little to promote health in local communities.

Follow Pamela Merritt on Twitter, @SharkFu