How a ballot initiative in Missouri is setting up another red-state test for abortion rights

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Andrew Feinberg

White House Correspondent

Supporters of abortion rights may be set up to deliver another decisive rebuke of conservative-led efforts to ban or restrict abortion at the state level.

A ballot initiative in Missouri appears to be picking up steam after clearing a key hurdle last week: a court challenge to its constitutionality, which argued that the language of the submitted ballot question was too vague for voters to understand. Amendment 3, which would enshrine abortion rights in the state’s constitution, was endorsed Monday by hundreds of medical professionals operating across the state in an open letter to news outlets.

The doctors and others who signed the letter are members of the Committee to Protect Health Care, a group which supports expanding access to low-cost healthcare.

The news of their endorsements comes on the heels of a heartbreaking report from ProPublica detailing the deaths of two women in Georgia who died as a result of inability to find timely medical care while experiencing complications with their pregnancies. On a more relevant note, it also follows the Missouri Supreme Court ruling just hours before ballots were printed that the measure will be up for a vote this year.

“Missourians are being denied abortions and forced to continue life-threatening pregnancies, risking their health and lives,” reads the letter, released by the Committee to Protect Health Care, in part. “Doctors can't treat patients with heartbreaking pregnancy complications until they are on the brink of death. Otherwise, they could be put in jail.”

“[W]e wholeheartedly support the Missourians for Constitutional Freedom ballot initiative to end our state's cruel, total abortion ban and put families — not politicians — back in charge of personal medical decisions. We endorse this initiative to give our patients and all Missourians the opportunity to directly vote on reproductive freedom, including access to abortion, miscarriage care, and birth control,” it also read.

A so-called “trigger ban” restricting abortion in all cases except severe medical emergencies went into effect in Missouri after Roe vs Wade was overturned in the Supreme Court’s ruling on Dobbs vs Jackson Women’s Health Organization in 2022. Such laws have been blamed for the deaths of women who are unable to find care before their conditions reach life-threatening stages.

“More than two years since our trigger abortion ban went into effect, it’s time voters had a say on our reproductive freedom,” Dr Jennifer Schmidt, one of the letter’s signatories, said Monday on a press call.

The letter is only a snowdrift in the avalanche that could be coming Republicans’ way in November.

Though the ballot initiative is opposed by anti-abortion groups and conservatives such as Mike Kehoe, the Trump-supported candidate in the governor’s race, it’s still likely on track to be a victory for abortion rights advocates this year. A poll in August showed the “pro” side winning with a nearly 20-point lead, and a focus on abortion rights by Vice President Kamala Harris’s campaign ahead of November could make that projected landslide a reality.

More than just how significant that decision will be for Missouri’s women, it’s also significant for the entire abortion rights movement. A victory in Missouri could very well end up being paired with one in Florida, which has a similar question on the ballot this year.

Dual wins in states that are likely to go for Donald Trump, the Republican nominee, at the presidential level would be a major messaging win for supporters of abortion rights and a sign that opponents of reproductive rights are playing on unfriendly territory even in America’s most conservative regions.

Defeats, by contrast, would be ammunition for conservatives like Byron Donalds, a Florida congressman and opponent of the state’s pro-abortion Amendment 4, who told The Independent earlier this year that he expects the politics of abortion to change significantly among younger generations now that Roe vs Wade is no longer in place at the federal level.

“The reality of post-Roe vs. Wade is nobody really knows what their position on abortion is. Like, I know my position. But I would say of the American people, that's still a moving target,” said the congressman in April. “But you can't jam that and force it. People have to get there.”