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Missouri Senate holds fate of women’s health care bill

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A wide-ranging women’s health care bill that stalled in the House for months over concerns about expanding coverage for birth control is a step away from the governor’s desk — though dysfunction in the Senate could derail its chances of becoming law.The bill, an effort by a bipartisan group of five women lawmakers across the House and Senate, would be “a game changer” for women’s health, said state Rep. Melanie Stinnett, a Republican from Springfield.With provisions focused on annual supply birth control, congenital syphilis, mammograms, STI treatment and rape test kits, the legislation is sponsored by Stinnett; state Sen. Elaine Gannon, a DeSoto Republican; State Rep. Tara Peters, a Rolla Republican; State Sen. Tracy McCreery, an Olivette Democrat; and state Rep. Patty Lewis, a Kansas City Democrat.“We need to focus on women’s health, children’s health, babies’ health,” Gannon said. “We have to do whatever we can do to produce healthy people.”Though it got its initial committee hearing in January, the House didn’t pass the bill and send it to the Senate until late April. The delay was caused by a number of Republicans expressing concerns that birth control could be used as an abortifacient, the bill’s sponsors said.Since passing the House with approval from 60 Republicans and 45 Democrats, it has moved quickly in the Senate and was approved unanimously by the chamber’s emerging issues committee on Monday.“This bill was on life support several times as it moved its way forward,” Lewis said. “But no matter what side of the aisle you’re on, it’s politically advantageous to support women’s health care right now.”The sponsors remain hopeful the bill can make it across the finish line before session ends on May 17.But progress in the Senate is stalled as infighting between the Freedom Caucus and Senate Republican leadership has left the chamber with little to show as they run up against a deadline to pass the state budget. Also hanging in limbo is a bill that would make it more difficult to pass citizen-led constitutional amendments, legislation Democrats have staunchly opposed, fearing it could inhibit an abortion rights proposal expected to land on the November ballot.The sponsors of the women’s health care bill argue that unlike other legislation, theirs should not be controversial and thus shouldn’t be a casualty of Senate gridlock.“If the supermajority knew how to govern, they could bulldoze anything through,” Lewis said. “But they are too busy fighting amongst themselves and ultimately playing games with people’s lives.”

Missouri Senate CommunicationsMissouri State Sen. Elaine Gannon speaks on the floor of the Senate in Jefferson City.

Annual supply birth controlPeters said if there’s one thing she’s learned in her freshman term in the House, it’s that all it takes to mount a campaign to kill a bill is the word “abortion.”The legislation, which would allow women on private insurance to pick up an annual supply of contraceptives rather than going to the pharmacy every few months, is already law in 26 states. Studies show this increase in access and continuity can help prevent unintended pregnancy. It does not apply to abortifacients.Stinnett, who has a master’s degree in health care administration and who serves as vice chair of the House Healthcare Reform Committee, said several Republican colleagues had questions about hormonal contraceptives and whether drugs that induce abortions fall under the statute.“At every turn we either had to educate or deflate or talk against what wasn’t true,” Peters said, adding that some lawmakers were spreading inaccurate information that the bill had to do with abortion drugs.After whipping the bill several times, Peters said she ultimately won over the needed support, finally moving the bill out of the House in late April, despite it receiving an initial House committee hearing in January.Only the Missouri Insurance Coalition and America’s Health Insurance Plans and Blue Cross Blue Shield of Kansas City were present to testify in opposition of the birth control policy.A recent survey released by The Right Time, a family planning initiative through the Missouri Family Health Council Inc., showed Missourians overwhelmingly support access to contraceptives,but some fear their lawmakers could pass laws limiting that availability.Of the 1,000 Missourians polled between the ages of 18 and 35, 77% said they believed there should be access to annual supplies of birth control.“I would have to dig pretty deep to find out when the last proactive sexual and reproductive health care legislation of a ‘women’s health type’ passed,” said Mandy Hagseth, the council’s director of policy and external affairs. “So it does not come often and it does not come easy.”Hagseth previously told The Independent that in conversations with women around Missouri, the council learned that access to clinics, lack of consistent transportation and balancing work and children are often barriers to picking up their contraception consistently, which can create gaps in use and increase the chances of an unintended pregnancy.More than 373,000 Missouri women live in contraceptive deserts,which they define as a place where there’s not reasonable access to a full range of contraceptive methods, according to data compiled by Power to Decide. Most are in rural counties.“The Senate has an opportunity to pass a really important, pro-active women’s health bill,” Hagseth said. “At a time that it’s woefully needed sort of generally and politically.”Congenital syphilis testingIn 2022, Missouri recorded 81 congenital syphilis cases — the most in 30 years, the state health department said in an alert distributed earlier this year.From 2017 to 2021, congenital syphilis cases rose 219% across the country; in Missouri, they rose 593%, according to the Centers for Disease Control and Prevention. Between 2012 and 2015, one stillbirth from a congenital syphilis case was reported in Missouri. Since then, there’s been at least one infant death every year, with 18 deaths reported between 2016 and 2022, according to the Missouri Department of Health and Senior Services.Mothers can pass along congenital syphilis in utero at any point in pregnancy. But if caught before the baby passes through the birth canal, the disease is reversible in the womb.For adults, the symptoms, if there are any, can include a rash on the palms of a person’s hands or on the soles of their feet, hair loss, swollen lymph nodes or sores. Often these symptoms go away on their own, even though they are still contagious. If a mother is infected within four weeks of delivering their baby and doesn’t get treatment, the infant has a 40% chance of dying at birth or shortly after, according to the CDC.Right now, only two syphilis tests are required in pregnancy: one in the first trimester and one at birth. The bill would also require a third trimester test for HIV and hepatitis C and hepatitis B, which can cause liver damage in infants.This legislation hopes to address this outbreak by adding additional optional testing for women around 28 weeks of pregnancy during their regularly-scheduled appointment.“Anything we can do to ensure that baby is born healthy, that’s what we need to be doing,” Gannon said.

Tim Bommel

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Missouri House Tracy McCreery, D-Olivette, speaks on the Missouri House Floor in 2022.

Mammograms, STI treatment and forensic examsMcCreery said after she went in for a mammogram at the start of the year, she received a “weird form letter” that left her thinking she needed additional testing to ensure she didn’t have breast cancer.New federal regulations for mammograms are now at odds with Missouri’s statute, so this bill would update the language given to patients after a cancer screening to be less confusing, as the current language may cause unnecessary concern.“We need to speak in clear, easy to understand terms when we’re communicating with somebody after they’ve had an exam like that,” McCreery said.The bill also hopes to make treatment easier for trichomoniasis, an infection that’s more common in women then men.Under current state statute, if someone is diagnosed with gonorrhea and chlamydia, their doctor is allowed to also treat the patient’s sexual partner in a process called expedited partner therapy. Under this legislation, trichomoniasis would also be added to that list, and it would open the door for syphilis to also be added if federal guidelines change as syphilis rates rise.The final piece of the legislation would smooth out a law passed in 2022 that requires survivors of rape or sexual assault be given the option to ask for a forensic exam.Right now, speciality hospitals without emergency departments are not exempt from the statute, meaning survivors can be taken to health care providers without access to rape test kits. This statute would require that patients initially seen at specialty hospitals be transferred to a hospital with an emergency department equipped to do a forensic exam.This story was originally published in The Missouri Independent, part of the States Newsroom.

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Poll: Support for Missouri abortion rights amendment growing

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A proposed constitutional amendment legalizing abortion in Missouri received support from more than half of respondents in a new poll from St. Louis University and YouGov.That’s a boost from a poll earlier this year, which could mean what’s known as Amendment 3 is in a solid position to pass in November.SLU/YouGov’s poll of 900 likely Missouri voters from Aug. 8-16 found that 52% of respondents would vote for Amendment 3, which would place constitutional protections for abortion up to fetal viability. Thirty-four percent would vote against the measure, while 14% aren’t sure.By comparison, the SLU/YouGov poll from February found that 44% of voters would back the abortion legalization amendment.St. Louis University political science professor Steven Rogers said 32% of Republicans and 53% of independents would vote for the amendment. That’s in addition to nearly 80% of Democratic respondents who would approve the measure. In the previous poll, 24% of Republicans supported the amendment.Rogers noted that neither Amendment 3 nor a separate ballot item raising the state’s minimum wage is helping Democratic candidates. GOP contenders for U.S. Senate, governor, lieutenant governor, treasurer and secretary of state all hold comfortable leads.“We are seeing this kind of crossover voting, a little bit, where there are voters who are basically saying, ‘I am going to the polls and I’m going to support a Republican candidate, but I’m also going to go to the polls and then I’m also going to try to expand abortion access and then raise the minimum wage,’” Rogers said.Republican gubernatorial nominee Mike Kehoe has a 51%-41% lead over Democrat Crystal Quade. And U.S. Sen. Josh Hawley is leading Democrat Lucas Kunce by 53% to 42%. Some GOP candidates for attorney general, secretary of state and treasurer have even larger leads over their Democratic rivals.

Brian Munoz

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St. Louis Public RadioHundreds of demonstrators pack into a parking lot at Planned Parenthood of St. Louis and Southwest Missouri on June 24, 2022, during a demonstration following the Supreme Court’s reversal of a case that guaranteed the constitutional right to an abortion.

One of the biggest challenges for foes of Amendment 3 could be financial.Typically, Missouri ballot initiatives with well-funded and well-organized campaigns have a better chance of passing — especially if the opposition is underfunded and disorganized. Since the end of July, the campaign committee formed to pass Amendment 3 received more than $3 million in donations of $5,000 or more.That money could be used for television advertisements to improve the proposal’s standing further, Rogers said, as well as point out that Missouri’s current abortion ban doesn’t allow the procedure in the case of rape or incest.“Meanwhile, the anti side won’t have those resources to kind of try to make that counter argument as strongly, and they don’t have public opinion as strongly on their side,” Rogers said.There is precedent of a well-funded initiative almost failing due to opposition from socially conservative voters.In 2006, a measure providing constitutional protections for embryonic stem cell research nearly failed — even though a campaign committee aimed at passing it had a commanding financial advantage.Former state Sen. Bob Onder was part of the opposition campaign to that measure. He said earlier this month it is possible to create a similar dynamic in 2024 against Amendment 3, if social conservatives who oppose abortion rights can band together.“This is not about reproductive rights or care for miscarriages or IVF or anything else,” said Onder, the GOP nominee for Missouri’s 3rd Congressional District seat. “Missourians will learn that out-of-state special interests and dark money from out of state is lying to them and they will reject this amendment.”Quade said earlier this month that Missourians of all political ideologies are ready to roll back the state’s abortion ban.“Regardless of political party, we hear from folks who are tired of politicians being in their doctor’s offices,” Quade said. “They want politicians to mind their own business. So this is going to excite folks all across the political spectrum.”

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Democrat Mark Osmack makes his case for Missouri treasurer

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Mark Osmack has been out of the electoral fray for awhile, but he never completely abandoned his passion for Missouri politics.Osmack, a Valley Park native and U.S. Army veteran, previously ran for Missouri’s 2nd Congressional District seat and for state Senate. Now he’s the Democratic nominee for state treasurer after receiving a phone call from Missouri Democratic Party Chairman Russ Carnahan asking him to run.“There’s a lot of decision making and processing and evaluation that goes into it, which is something I am very passionate and interested in,” Osmack said this week on an episode of Politically Speaking.Osmack is squaring off against state Treasurer Vivek Malek, who was able to easily win a crowded GOP primary against several veteran lawmakers including House Budget Chairman Cody Smith and state Sen. Andrew Koenig.While Malek was able to attract big donations to his political action committee and pour his own money into the campaign, Osmack isn’t worried that he won’t be able to compete in November. Since Malek was appointed to his post, Osmack contends he hasn’t proven that he’s a formidable opponent in a general election.“His actions and his decision making so far in his roughly two year tenure in that office have been questionable,” Osmack said.Among other things, Osmack was critical of Malek for placing unclaimed property notices on video gaming machines which are usually found in gas stations or convenience stores. The legality of the machines has been questioned for some time.As Malek explained on his own episode of Politically Speaking, he wanted to make sure the unclaimed property program was as widely advertised as possible. But he acknowledged it was a mistake to put the decals close to the machines and ultimately decided to remove them.Osmack said: “This doesn’t even pass the common sense sniff test of, ‘Hey, should I put state stickers claiming you might have a billion dollars on a gambling machine that is not registered with the state of Missouri?’ If we’re gonna give kudos for him acknowledging the wrong thing, it never should have been done in the first place.”Osmack’s platform includes supporting programs providing school meals using Missouri agriculture products and making child care more accessible for the working class.He said the fact that Missouri has such a large surplus shows that it’s possible to create programs to make child care within reach for parents.“It is quite audacious for [Republicans] to brag about $8 billion, with a B, dollars in state surplus, while we offer next to no social services to include pre-K, daycare, or child care,” Osmack said.Here’s are some other topics Osmack discussed on the show:How he would handle managing the state’s pension systems and approving low-income housing tax credits. The state treasurer’s office is on boards overseeing both of those programs.Malek’s decision to cut off investments from Chinese companies. Osmack said that Missouri needs to be cautious about abandoning China as a business partner, especially since they’re a major consumer of the state’s agriculture products. “There’s a way to make this work where we are not supporting communist nations to the detriment of the United States or our allies, while also maintaining strong economic ties that benefit Missouri farmers,” he said.What it was like to witness the skirmish at the Missouri State Fair between U.S. Sen. Josh Hawley and Democratic challenger Lucas Kunce.Whether Kunce can get the support of influential groups like the Democratic Senatorial Campaign Committee, which often channels money and staff to states with competitive Senate elections.

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As Illinois receives praise for its cannabis equity efforts, stakeholders work on system’s flaws

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Medical marijuana patients can now purchase cannabis grown by small businesses as part of their allotment, Illinois’ top cannabis regulator said, but smaller, newly licensed cannabis growers are still seeking greater access to the state’s medical marijuana customers.Illinois legalized medicinal marijuana beginning in 2014, then legalized it for recreational use in 2020. While the 2020 law legalized cannabis use for any adult age 21 or older, it did not expand licensing for medical dispensaries.Patients can purchase marijuana as part of the medical cannabis program at dual-purpose dispensaries, which are licensed to serve both medical and recreational customers. But dual-purpose dispensaries are greatly outnumbered by dispensaries only licensed to sell recreationally, and there are no medical-only dispensaries in the state.As another part of the adult-use legalization law, lawmakers created a “craft grow” license category that was designed to give more opportunities to Illinoisans hoping to legally grow and sell marijuana. The smaller-scale grow operations were part of the 2020 law’s efforts to diversify the cannabis industry in Illinois.Prior to that, all cultivation centers in Illinois were large-scale operations dominated by large multi-state operators. The existing cultivators, mostly in operation since 2014, were allowed to grow recreational cannabis beginning in 2019.Until recently, dual-purpose dispensaries have been unsure as to whether craft-grown products, made by social equity licensees — those who have lived in a disproportionately impacted area or have been historically impacted by the war on drugs — can be sold medicinally as part of a patient’s medical allotment.Erin Johnson, the state’s cannabis regulation oversight officer, told Capitol News Illinois last month that her office has “been telling dispensaries, as they have been asking us” they can now sell craft-grown products to medical patients.“There was just a track and trace issue on our end, but never anything statutorily,” she said.

Dilpreet Raju

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Capitol News IllinoisThe graphic shows how cannabis grown in Illinois gets from cultivation centers to customers.

No notice has been posted, but Johnson’s verbal guidance comes almost two years after the first craft grow business went online in Illinois.It allows roughly 150,000 medical patients, who dispensary owners say are the most consistent purchasers of marijuana, to buy products made by social equity businesses without paying recreational taxes. However — even as more dispensaries open — the number available to medical patients has not increased since 2018, something the Cannabis Regulation Oversight Office “desperately” wants to see changed. Johnson said Illinois is a limited license state, meaning “there are caps on everything” to help control the relatively new market.Berwyn Thompkins, who operates two cannabis businesses, said the rules limited options for patients and small businesses.“It’s about access,” Thompkins said. “Why wouldn’t we want all the patients — which the (adult-use) program was initially built around — why wouldn’t we want them to have access? They should have access to any dispensary.”Customers with a medical marijuana card pay a 1% tax on all marijuana products, whereas recreational customers pay retail taxes between roughly 20 and 40% on a given cannabis product, when accounting for local taxes.While Illinois has received praise for its equity-focused cannabis law, including through an independent study that showed more people of color own cannabis licenses than in any other state, some industry operators say they’ve experienced many unnecessary hurdles getting their businesses up and running.The state, in fact, announced last month that it had opened its 100th social equity dispensary.But Steve Olson, purchasing manager at a pair of dispensaries (including one dual-purpose dispensary) near Rockford, said small specialty license holders have been left in the lurch since the first craft grower opened in October 2022.“You would think that this would be something they’re (the government) trying to help out these social equity companies with, but they’re putting handcuffs on them in so many different spots,” he said. “One of them being this medical thing.”Olson said he contacted state agencies, including the Department of Financial and Professional Regulation, months ago about whether craft products can be sold to medical patients at their retail tax rate, but only heard one response: “They all say it was an oversight.”This potentially hurt social equity companies because they sell wholesale to dispensaries and may have been missing out on a consistent customer base through those medical dispensaries.Olson said the state’s attempts to provide licensees with a path to a successful business over the years, such as with corrective lotteries that granted more social equity licenses, have come up short.“It’s like they almost set up the social equity thing to fail so the big guys could come in and swoop up all these licenses,” Olson said. “I hate to feel like that but, if you look at it, it’s pretty black and white.”Olson said craft companies benefit from any type of retail sale.“If we sell it to medical patients or not, it’s a matter of, ‘Are we collecting the proper taxes?’ That’s all it is,” he said.State revenue from cannabis taxes, licensing costs and other fees goes into the Cannabis Regulation Fund, which is used to fund a host of programs, including cannabis offense expungement, the general revenue fund, and the R3 campaign aiming to uplift disinvested communities.For fiscal year 2024, nearly $256 million was paid out from Cannabis Regulation Fund for related initiatives, which includes almost $89 million transferred to the state’s general revenue fund and more than $20 million distributed to local governments, according to the Illinois Department of Revenue.Medical access still limitedThe state’s 55 medical dispensaries that predate the 2020 legalization law, mostly owned by publicly traded multistate operators that had been operating in Illinois since 2014 under the state’s medical marijuana program, were automatically granted a right to licenses to sell recreationally in January 2020. That gave them a dual-purpose license that no new entrants into the market can receive under current law.Since expanding their clientele in 2020, Illinois dispensaries have sold more than $6 billion worth of cannabis products through recreational transactions alone.Nearly two-thirds of dispensaries licensed to sell to medical patients are in the northeast counties of Cook, DuPage, Kane, Lake and Will. Dual-purpose dispensaries only represent about 20 percent of the state’s dispensaries.While the state began offering recreational dispensary licenses since the adult-use legalization law passed, it has not granted a new medical dispensary license since 2018. That has allowed the established players to continue to corner the market on the state’s nearly 150,000 medical marijuana patients.But social equity licensees and advocates say there are more ways to level the playing field, including expanding access to medical sales.Johnson, who became the state’s top cannabis regulator in late 2022, expressed hope for movement during the fall veto session on House Bill 2911, which would expand medical access to all Illinois dispensaries.“We would like every single dispensary in Illinois to be able to serve medical patients,” Johnson said. “It’s something that medical patients have been asking for, for years.”Johnson said the bill would benefit patients and small businesses.“It’s something we desperately want to happen as a state system, because we want to make sure that medical patients are able to easily access what they need,” she said. “We also think it’s good for our social equity dispensaries, as they’re opening, to be able to serve medical patients.”Rep. Bob Morgan, D-Deerfield, who was the first statewide project coordinator for Illinois’ medical cannabis program prior to joining the legislature, wrote in an email to Capitol News Illinois that the state needs to be doing more for its patients.“Illinois is failing the state’s 150,000 medical cannabis patients with debilitating conditions. Too many are still denied the patient protections they deserve, including access to their medicine,” Morgan wrote, adding he would continue to work with stakeholders on further legislation.Capitol News Illinois is a nonprofit, nonpartisan news service covering state government. It is distributed to hundreds of newspapers, radio and TV stations statewide. It is funded primarily by the Illinois Press Foundation and the Robert R. McCormick Foundation, along with major contributions from the Illinois Broadcasters Foundation and Southern Illinois Editorial Association.

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