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I am among the majority of Missourians who voted in favor of expanding Medicaid in 2020. I am also among the majority of Missourians astounded by the legislative maneuvers and litigation saga that followed, even after the people had spoken on the issue.

Seventy-six percent of Missouri residents, including large majorities across the political spectrum, believe the state legislature should increase access to birth control for Missourians, according to a new public opinion survey.

"Missouri being party to this lawsuit doesn’t change the need for high-quality, patient-centered family planning services or the many barriers Missourians face accessing healthcare," said Michelle Trupiano, executive director of the Missouri Family Health Council.

Sunday was World Contraception Day, an annual celebration to improve awareness of birth control and enable individuals to make informed choices about their sexual and reproductive health. During a standard year, it’s a time to reflect on the transformative impact of birth control. But this year – after the Missouri legislature risked destabilizing the entire state budget to eliminate IUDs and emergency contraception from the state Medicaid program – it’s something else entirely: a cautionary tale.

On Sept. 26, the world will unite for a global event to raise awareness for protecting and improving access to family planning services that are vital for so many. World Contraception Day allows us to reflect on the ways society can continue to enable all people to make informed decisions regarding their health care.

The Missouri Family Health Council, which administers funding for a statewide network of family planning clinics, has said nearly half of its members’ 38,000 mostly low-income patients go to a Planned Parenthood facility.

Although much of the focus over the past six months has been the COVID-19 vaccine — an equally important component of a strong public health safety net — there are additional vaccines for students that merit mentioning.

Today marks a significant milestone for contraceptive equity in America: 22 years ago, the Food and Drug Administration approved emergency contraception brand, Plan B, for prescription use.

Of the 38,000 primarily low-income women who visited the Missouri Family Health Council’s statewide member clinics for family planning services, 48% went to a Planned Parenthood, spokeswoman Leslie Pritchard said.

"Tonight, the State Senate chose to pass an FRA that removed dangerous language equating birth control to abortion and limiting safety-net providers," Trupiano said. "We applaud the Senators who put people over politics tonight and ushered in a bipartisan resolution on this."

"The state Senate chose to pass [legislation] that removed dangerous language equating birth control to abortion and limiting safety-net providers," said Michelle Trupiano, executive director of Missouri Family Health Council, Inc. "This is a win for science."

"This is a win for science, MO HealthNet patients, and all Missourians [...]," said Michelle Trupiano, Executive Director of Missouri Family Health Council, Inc.

"The message is clear: it is not a winning strategy to use birth control – which is essential healthcare – as a bargaining chip," said Michelle Trupiano, executive director of the Missouri Family Health Council, which supports broader access to contraception.

“Conflating birth control methods with abortion-inducing drugs is designed to confuse and create uncertainty," said Michelle Trupiano, the executive director of the Missouri Family Health Council, Inc. "The concern with the language is that it will be left up to interpretation by non-medical professionals and could have a chilling effect on medical professionals and the use of IUDs, because it will create this uncertainty that folks will not be really sure what is and isn’t allowed."

[Trupiano] said the legislation would have a "chilling effect" on providers and "no doubt will limit access to certain methods for those that are on Medicaid."

"There are certain legislators that are conflating abortion and birth control, and what folks need to know is that these legislators are trying to take away access to certain forms of contraception, including emergency contraception," Trupiano said.

"Contraceptive prevents pregnancy, including these methods that the legislature is considering limiting. It doesn’t interrupt a pregnancy," said Dr. Elizabeth Allemann, medical director of the Missouri Family Health Council and a practicing physician. "Statements in the law should be true."

"Missourians deserve better," Executive Director for Missouri Family Health Council Michelle Trupiano said. "Birth control should be accessible for everyone regardless of their income or health insurance."

“This language tries to equate contraception with abortion. And that is highly irresponsible in that the two are not the same," Trupiano said. "So the impact that this would have is that, especially low-income women, would not have access to the full range of contraceptive methods, and they’d be forced to choose a method that is not actually right for them."

IUDs and implants made up 16% of the chosen methods last year for roughly 31,000 mostly low-income women who sought contraceptives from the Missouri Family Health Council’s clinics statewide, said director Michelle Trupiano.

"‘It is purposefully and irresponsibly conflating abortion and birth control,’ Trupiano said.”

This May, we observe Sex Ed for All month, a campaign highlighting the critical need for equitable and accessible sexuality education for all young people.

The COVID-19 pandemic has highlighted the importance of investing in public health for the public good. The backbone of the public health sector always has been, and always will be, nurses.

The Missouri legislature returned from its annual spring break and wasted no time putting the health care of almost 1 million Missourians in jeopardy. The Senate recently added an anti-birth control amendment to a mandatory Medicaid spending bill, which prohibits the program from providing some forms of birth control. This restrictive and dangerous amendment is a direct attack on those seeking family planning services and even threatens our whole Medicaid funding by putting the program out of compliance with federal law. Additionally, the legislature added unlawful language to the budget that prevents patients from seeing the provider of their own choice, further threatening Missouri's Medicaid funding.

We at the National Council of Jewish Women St. Louis were stunned to learn that Missouri state Sen. Paul Wieland, R-Imperial, recently offered an amendment that will do unprecedented harm to our state’s mandatory Medicaid funding bill. Though his intention was to make it even more difficult to obtain an abortion in Missouri, under his amendment, any Food and Drug Administration-approved medication or device that would destroy or prevent a fertilized egg from implanting in the uterus would be prohibited.

While playing politics with healthcare in Missouri is certainly nothing new, holding Missouri Medicaid hostage over basic birth control is a stunning — and consequential — shift.

Public health leaders have been working day and night to respond to the coronavirus. But it is not all they do. Mid-Missouri public health organizations promote well-being in a variety of ways; but a global pandemic still takes precedence.

A month ago, President Joe Biden’s administration issued an executive memorandum on women’s health. Among other things, the memo directed the Department of Health and Human Services to review and consider rescinding Donald Trump-era regulations for the Title X federal family planning program. A month ago, this was an adequate — even celebratory — first step. But too much is on the line to wait any longer. Missouri needs relief now.

"As Executive Director of the Missouri Family Health Council, which helps to provide low- and no-cost reproductive health care across the state, Michelle Trupiano is used to navigating a challenging political environment. 'I’m from Missouri, I work in Missouri, and Missouri’s a conservative state where our providers, in general, are used to an onslaught of attacks on reproductive health,' she said."

“We’re disappointed the Biden administration did not suspend the dangerous Title X ‘gag rule,’” read a statement by Michelle Trupiano, the executive director of Missouri Family Health Council, which is the sole Title X grantee for the state. “But we’re encouraged that the President has placed such an emphasis on access to quality, affordable healthcare so early in his term.”

The state of Missouri is, once again, playing politics with reproductive and sexual health care, trying to restrict access to highly qualified and experienced providers in its Medicaid family planning program.

Does anyone really support the notion that decisions about women’s health should be made by their employers? Unfortunately, the Supreme Court does.

Planned Parenthood and Spectrum Health Care in Columbia have joined a network that provides free or low-cost contraceptive services to women in Missouri.

Ten months into a six-year, $20 million effort to expand contraceptive access in Missouri, some 9,000 patients have obtained some form of birth control, totally free — and not a dime of it is government money…

Family planning officials in states with anti-choice restrictions see the new Title X rules as yet another barrier to health care for people with low incomes…

Family planning clinics that take Title X funding are banned from referring patients for abortions…

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