Commission, not court, deciding fate of abortion in Missouri

ST. LOUIS (AP) — The battle to keep open Missouri’s only abortion clinic has moved from the courts to a state administrative process, adding to the confusion about the future of the Planned Parenthood-operated clinic in St. Louis.

No state has been without a functioning abortion clinic since 1974, the year after the landmark U.S. Supreme Court’s Roe v. Wade ruling that legalized the procedure nationwide.

Here is a look at the uncertain situation involving abortions in Missouri.


Q: What led to the abortion license battle in Missouri?

A: The issue comes amid a backdrop of anti-abortion efforts by lawmakers. Missouri is among several conservative states to pass new restrictions on abortions in the hope that the increasingly conservative U.S. Supreme Court will eventually overturn Roe v. Wade. Republican Gov. Mike Parson signed legislation in May banning abortions at or beyond eight weeks of pregnancy, with exceptions for medical emergencies but not for rape or incest.

During an annual inspection of the St. Louis clinic in March, Missouri health investigators cited numerous concerns, including reports of failed abortions.

Planned Parenthood said it has already addressed those concerns and defended its clinic. It claims the state is using the licensing process as an excuse to stop abortions.

The state initially let the clinic’s abortion license lapse at the end of May, then announced more definitively last week that it would not renew the license. A judge’s rulings have kept the clinic open, but only until 5 p.m. Friday. Judge Michael Stelzer’s ruling from last week also stated that the license issue should be resolved by the state Administrative Hearing Commission, not the courts.


Q: What happens now that the issue is before the Administrative Hearing Commission?

A: The commission, or AHC, is the entity that addresses licensing disputes between state agencies and businesses. Each case is assigned to one of the AHC’s four commissioners. The abortion case was assigned to Sreenivasa Rao Dandamudi, an appointee of former Gov. Jay Nixon, a Democrat.

A hearing date was set for Aug. 1. The hearing could last anywhere from hours to several days, depending on how much evidence both sides choose to present.

The problem for Planned Parenthood is that the abortion license expires Friday, and Dandamudi’s ruling would be in August at the earliest.

The commission has the option of granting a stay, which would keep the clinic open pending a ruling. Planned Parenthood has requested a stay, but it’s unclear when Dandamudi will decide whether to grant it.

Jennifer Sandman, deputy director of Public Policy Litigation and Law for the Planned Parenthood Federation of America, said in a statement to The Associated Press on Thursday that if the clinic is forced to close, “we will pursue every legal option to seek further relief from the court.”


Q: What is a hearing before the Administrative Hearing Commission like?

A: According to the AHC’s website, the hearing process is similar to a trial, but less formal. Representatives for each side, probably lawyers, make opening statements and present evidence, which could include testimony, documents or both. Both sides also will have a period after the hearing to file additional written evidence. Dandamudi will then review all the evidence and issue a decision in writing, though it’s unclear when.


Q: If the St. Louis clinic closes, what options are available for Missouri women seeking abortions?

A: Missourians already are increasingly traveling to clinics elsewhere, particularly in neighboring Illinois and Kansas. Missouri health department statistics show that abortions have declined every year over the past decade in the state, dropping to 2,910 last year.

But the Hope Clinic in Granite City, Illinois, just 10 miles (16 kilometers) from St. Louis, has seen a big increase in Missouri clients since 2017, said Alison Dreith, the clinic’s deputy director. That year, Missouri adopted a more restrictive abortion law, including giving the attorney general power to prosecutor violations.

Dreith said about 55% of patients at Hope Clinic are from Missouri, 40% from Illinois and 5% from elsewhere around the country. The clinic attracts clients from across the U.S. in part because Illinois allows the procedure for up to 24 weeks of pregnancy, longer than most states, she said.

The Granite City clinic saw about 3,000 patients in 2017, 3,800 last year (after Missouri adopted stricter abortion standards), and is on pace for well over 4,000 in 2019. Dreith attributes much of this year’s increase to a 30% rise in Missouri patients, many of whom cited uncertainty about the future of abortion in Missouri.

Kansas health department data indicates that 3,300 of the 7,000 abortions performed there last year involved Missouri residents. Kansas has an abortion clinic in Overland Park, a Kansas City suburb just 2 miles (3 kilometers) from the state line.