JEFFERSON CITY, Mo. — The Missouri Supreme Court ruled Tuesday that a Missouri law prohibiting Medicaid payments to abortion providers was unconstitutional.

Planned Parenthood sued the state two years ago after Missouri lawmakers changed the state budget to exclude abortion providers and any related affiliates from Medicaid. It is the sole abortion provider in the state, with a clinic in St. Louis.

In a 6-1 ruling, the court found that the Missouri Constitution does not allow for bills to cover more than one subject, and that including what the state should — as well as what it should not — fund violated that clause.

It vacated the portion of the Department of Social Service’s budget with that caveat, but left the rest of the budget bill intact.

The Supreme Court called the General Assembly’s actions a “naked attempt” to legislate through the budget bill.

“When the meaning of the general law is clear, there is no need for ‘guidance’ in an appropriation bill,” Judge Paul C. Wilson wrote in the ruling.

Only Judge Zel Fischer dissented, arguing that the Missouri Constitution’s single-subject clause exempts budget bills.

The Missouri Supreme Court’s decision affirmed a lower court ruling, which found that lawmakers were making a substantive change to statute through a budget bill.

“Missourians need access to health care, and today’s decision is a great win for patients who rely on Planned Parenthood for sexual and reproductive health care,” Yamelsie Rodriguez, CEO of Planned Parenthood of the St. Louis Region and Southwest Missouri, said in a statement. “Planned Parenthood will continue to provide the same high-quality, affordable, accessible health care Missourians have relied on for more than 85 years.”

The Missouri Attorney General’s Office, which represented the Missouri Department of Social Services in the case, said it found the decision “disappointing,” but declined to comment further.

As of November of last year, the state of Missouri has withheld more than $1 million in Medicaid payments since mid-2018 for cancer screenings, sexually transmitted disease (STD) testing and birth control that the organization’s clinics around the state provide to low-income patients. Though recent figures were not readily available, that number has only grown.

Medicaid dollars cannot be used to pay for abortions. The organization’s 11 clinics in Missouri provide non-abortion-related services.

While the Planned Parenthood lawsuit contested a change made to the budget in 2018, lawmakers have included similar language in state budgets passed last year and this year.

A lawsuit contesting the 2019 change is pending in Jackson County Circuit Court, and was brought by the Planned Parenthood affiliate that covers its clinics in Columbia and Kansas City.

“The Missouri Supreme Court’s decision makes clear what we knew all along: Missourians who rely on Medicaid deserve access to care from Planned Parenthood’s health centers across the state,” Brandon Hill, CEO of the Planned Parenthood of the Great Plains, said in a statement.

The 2019 budget language is largely the same as the one the Supreme Court found unconstitutional, according to Planned Parenthood’s attorney Chuck Hatfield. He said he planned to invoke the Supreme Court’s Tuesday ruling to expedite a judgment in the case pending in the lower court.

“Today’s case resolved for Planned Parenthood of the St. Louis Region the same issues our affiliate raised in a companion case in Kansas City, and we’re pleased to get back to doing what we do best — focusing on patients,” Hill said in a statement. “We look forward to continuing in the Medicaid program for years to come.”

This is Planned Parenthood’s second major win this year against the state.

On May 29, an administrative hearing commissioner found that the state erred in yanking its St. Louis clinic’s license to perform abortions. The yearlong fight was settled with the state has reissuing a license to the clinic and announcing it would not appeal the decision.

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