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In a unanimous decision that could have an impact on how lawmakers craft the state’s upcoming budget, the high court sided with a Cole County judge’s ruling that lawmakers cannot use the budgeting process to block Medicaid funding to the health provider.

It marked the second time in three years the court weighed in on the General Assembly’s bid to force Planned Parenthood out of business in Missouri, even though abortion is illegal now.

While the state’s Medicaid program doesn’t reimburse for abortions, Planned Parenthood has previously sought reimbursements for other medical procedures. When it sued the state, the group said the latest legislative maneuver resulted in an end to reimbursements for birth control, cancer screenings, sexually transmitted disease testing and treatment, and other non-abortion care.

The court was acting on a decision by Cole County Circuit Judge Jon Beetem, who affirmed a 2020 by the Missouri Supreme Court. In that case, the court called the Legislature’s action a “naked attempt” to legislate through a budget bill, rather than implementing policy changes through stand-alone pieces of legislation.

In arguments in November, Republican Attorney General Andrew Bailey’s office called on the judges to preserve the right for lawmakers to make budgeting decisions.

Bailey’s office asked the court to overrule Beetem because Planned Parenthood did not exhaust its administrative remedies.

But, writing for the majority, Judge Brent Powell rejected that argument.

“Only courts within the Missouri judiciary, not tribunals under the state’s executive branch, have the authority to determine a statute or legislative enactment to be unconstitutional,” Powell wrote.

While the issue is similar in scope to a 2020 decision, there are three new members of the seven-person bench since that ruling was handed down, each appointed by Republican Gov. Mike Parson.

Secretary of State Jay Ashcroft, who is campaigning to replace the term-limited Parson, lashed out at the court’s decision and pledged to choose judges who are more conservative than Parson’s picks.

“Liberal judges are doing everything possible to fund Planned Parenthood with taxpayer dollars! We need a Governor who will pick originalists and not activists!,” Ashcroft said on social media.

Five of the seven justices were appointed by Republicans like Parson. Four are women.

In a joint statement, Yamelsie Rodriguez, president and CEO of Planned Parenthood of the ӣ����Ƶ Region and Southwest Missouri, and Emily Wales, president and CEO of Planned Parenthood Great Plains, said the organization is a critical part of an already-stretched safety net.

"The politicians making these attacks don’t care that they will be denying Missourians health care — they want to score political points by targeting Planned Parenthood. This is cruel and irresponsible," they said.

“The fight for patient access is far from over. At Planned Parenthood, we will continue to do all we can in order to ensure our patients keep their access to health care — our doors stay open,” they added.

In the House and Senate, meantime, Republicans are attempting to sidestep the court decision by pressing for passage of a stand-alone bill that would keep money from flowing to Planned Parenthood.

In a House committee Tuesday, opponents testified that defunding the organization is an attack on women.

“Denying Planned Parenthood from receiving Medicaid reimbursement does nothing more than poke more holes in our state’s already thin and under resourced medical safety net,” said Amy Hammerman of the National Council of Jewish Women ӣ����Ƶ.

In written testimony to the committee, Maggie Edmondson of Abortion Action Missouri, formerly Pro Choice Missouri, said, “Every Missourian should have access to the full range of reproductive health care. This basic right is the foundation of freedom and opportunity for Missourians and their families.”

Supporters of defunding Planned Parenthood say its Missouri clinics are affiliated with clinics operating in states where abortion is legal and should not receive money from taxpayers.

(Note: Comments by Planned Parenthood were added after this story was published.)