Opinion -- 85% of Missourians Support Access to Birth Control

By the Beacon Reproductive Health Network and the Missouri Foundation for Health

A new poll released through Missouri Foundation for Health’s The Right Time initiative shows strong public support for access to birth control while highlighting concerns about future barriers to care—underscoring the need for lawmakers to advance policies that expand access to birth control across the state.

According to the poll, 85.3% of respondents are supportive of Missouri residents 18 and over having access to all methods of birth control, and 77.3% believe elected officials should be supportive of access to birth control.

At the same time, many Missourians are worried about the future of access. More than one-third of respondents (36.5%) believe birth control will become more difficult or impossible to obtain, and 78% say they are concerned about elected officials enacting laws that restrict access to birth control.

The polling also highlights real barriers people currently face when trying to access birth control. Nearly one in four respondents (24.9%) say cost or insurance has made it difficult to obtain the birth control method they wanted, while one-third (33.6%) report concerns about the cost of birth control.

“Missourians are sending a clear message: people want access to birth control, and they want leaders who will support policies that make it easier to get the care they need,” said Michelle Trupiano, Executive Director of Beacon Reproductive Health Network. “When people are already facing barriers like cost, insurance coverage, and clinic access, strengthening Missouri’s reproductive health safety net is more important than ever.”

Advocates say the findings highlight the importance of advancing policies that expand birth control access in Missouri. With the Missouri General Assembly currently considering legislation that could affect access to reproductive health care, measures like Annual Supply of Contraception—which allows patients to receive a year’s supply of birth control at once—and the Compassionate Assistance for Rape Emergencies (CARE) Act—which would ensure survivors are offered emergency contraception in hospital emergency departments—would help reduce barriers and ensure Missourians can access care when they need it.

The poll shows strong support for these approaches, with 73.7% of respondents supporting access to a full year’s supply of birth control and 80.8% supporting access to emergency contraception for survivors of sexual assault in emergency departments.

“Policies like Annual Supply of Contraception and the CARE Act are practical solutions that reflect what Missourians want—reliable access to birth control and the freedom to make decisions about their health and futures,” Trupiano said.

Programs like The Right Time initiative also strengthen Missouri’s reproductive health safety net. Through a network of participating health centers across the state, The Right Time helps patients receive same-day contraceptive care and choose the method that works best for them while reducing cost barriers by offering free or low-cost options.

About the Survey

The results presented here are based on an online survey of 1,000 Missouri residents ages 18-35 conducted in March 2026 by AYTM, an independent research organization. The margin of error is approximately +/- 3.10% at a 95% confidence level.

Opinion -- As Medicaid Turns 60, Its Future Hangs in the Balance

By Sheldon Weisgrau

Missouri holds a central role in the history of health care in the United States. Sixty years ago, on July 30, 1965, President Lyndon B. Johnson traveled to Independence, Missouri, to stand side-by-side with native son Harry S. Truman and signed the Medicare and Medicaid Act into law. This historic legislation, which passed Congress with overwhelming bipartisan support, provided health insurance coverage to millions of Americans who were previously left out: seniors over the age of 65 (Medicare) and low-income individuals and families (Medicaid). Together, these programs serve as the foundation of our health care system. Today, Medicare and Medicaid provide health insurance coverage to 144 million people, or more than 4 in 10 Americans. Two-and-a-half million Missourians rely on these programs.

Cuts to Medicare have long been considered a political “third rail,” with politicians reluctant to tamper with a program that is viewed favorably by 82% of Americans, including large majorities of Democrats, Independents, and Republicans. Medicaid, despite nearly equal popularity, with 77% support, hasn’t proven as invulnerable. The recently passed federal budget bill will extend the tax cuts passed during the first Trump administration and add more than $3 trillion to the national debt. It also slashes $1 trillion from Medicaid over the next 10 years, the largest cut in health care funding in history. Nearly 12 million Americans, and more than 130,000 Missourians, will lose their health care coverage.

These cuts threaten the very foundations of Medicaid and the health care safety net. More than 1.25 million Missourians, about half of them children, rely on MO HealthNet (Missouri’s Medicaid program) for preventive care, doctor and hospital visits, laboratory and diagnostic services, and prescription drugs. MO HealthNet covers services across the life spectrum, paying for nearly 4 in 10 births and two-thirds of nursing home care in the state.

Those covered by Medicaid are more likely to receive preventive care, get timely treatment for cancer and other serious illnesses, and fill their prescriptions than those without insurance. Medicaid serves as the leading payer for mental and behavioral health and family planning services. The program reduces racial, ethnic, and rural health disparities; enhances health; and lowers mortality.

Medicaid provides other benefits as well. It improves high school and college graduation rates. Children who are covered by Medicaid earn more and require less health care as adults. By eliminating catastrophic out-of-pocket medical costs, Medicaid reduces debt (a significant problem in Missouri) and lowers poverty rates for families.

The program also reinvests tax dollars into the economy, creating jobs and economic growth in Missouri communities and supporting rural hospitals and other health care providers. (A special rural health fund included in the budget bill will offset only a fraction of the losses that will be suffered by rural health providers – currently more than 20 rural Missouri hospitals are at risk of closure).

For 60 years, Medicaid has delivered a valuable return on investment by providing a safety net for low-income Americans and an economic engine for neighborhoods and communities. As we celebrate its anniversary in the face of cuts that threaten to roll back so much of the security it provides, it is instructive to remember the words of President Johnson in 1965:

“Few can see past the speeches and the political battles to the doctor over there that is tending the infirm, and to the hospital that is receiving those in anguish, or feel in their heart painful wrath at the injustice which denies the miracle of healing to the old and to the poor… There is another tradition that we share today. It calls upon us never to be indifferent toward despair. It commands us never to turn away from helplessness. It directs us never to ignore or to spurn those who suffer untended in a land that is bursting with abundance.”

Medicaid is not “waste, fraud, and abuse.” It is not intended to separate the “deserving” from the “undeserving.” Medicaid is a vital lifeline for Missourians in their times of greatest adversity or misfortune. It has survived the political ups and downs of the past six decades largely intact. If we are unable to reverse course, the catastrophic reductions that we make today will lead to a sicker, less prosperous country tomorrow.

In the coming months, MFH will assess the future impacts of these dire cuts, inform the public and policymakers of their significance, and work with partners across the state and the nation to rebuild this critical program.

Mr. Weisgrau is the Vice President of Health Policy and Advocacy for the Missouri Foundation for Health.

Opinion -- Cuts to Medicaid are Cuts to All

By the Missouri Foundation for Health

The U.S. Congress is currently at work on a budget to set future tax and spending policy. As the House and Senate quickly work through the process (leaders have targeted Memorial Day to complete the measure) it’s important to understand what’s at stake – the very future of Medicaid as we know it.

The extension of the tax cuts enacted during President Trump’s first term, which are estimated to cost $4.5 trillion over the next 10 years, is a top priority for congressional Republicans. To help “pay for” these tax cuts, they aim to pull $880 billion from the Medicaid program. Cuts of this scale would have profound effects, terminating health coverage for millions of Americans and upending the stability of the entire health care system.

Medicaid, known as MO HealthNet in Missouri, is the federal-state partnership that provides health insurance to low-income children, seniors, people with disabilities, pregnant women, and working families. The proposed cuts, 10% of the federal share of program costs, threaten not only those covered by Medicaid, but everyone who relies on a stable health system, a solvent state budget, and a thriving economy. So, all of us.

About 1.3 million Missourians – one in five state residents – are enrolled in MO HealthNet, which pays for preventive services, doctor and hospital visits, laboratory and diagnostic services, and prescription drugs. It covers 4 in 10 births in Missouri and is the state’s largest payer of mental and behavioral health services.

MO HealthNet covers care and equipment that allows seniors and people with disabilities to remain in their homes and communities. When staying at home is no longer possible, it covers long-term care, paying for two-thirds of all nursing home care in the state. MO HealthNet touches every part of the health care system in every corner of Missouri, from the largest regional medical centers to the smallest rural health clinics.

What would Medicaid cuts mean for Missouri? Missouri Foundation for Health analyzed the effects of various proposals being considered by Congress. All would shift a massive amount of funding responsibility from the federal government to the state and terminate health coverage for tens of thousands of Missourians. 

Depending on the plan adopted, Missouri could see as much as a quarter of its federal funding cut – more than $3.9 billion per year – and as many as 350,000 people could lose health coverage. The impact could be even deeper if Congress combines several of the proposals under consideration.

Missouri, like all states, relies heavily on the federal government to pay for health care. This partnership has always shaped Medicaid: state residents pay federal taxes, some of which come back home to ensure that everyone receives the care they need, including people fighting cancer, seniors in nursing homes, children, veterans, and people with disabilities.

Medicaid delivers nearly $13 billion into the state each year, comprising 70% of the MO HealthNet budget. If reduced, the effects will ripple through the program, through the state budget, and through the state economy.

For example, seniors in nursing homes and individuals with disabilities account for about half of all MO HealthNet costs. Funding likely can’t be cut without dramatically reducing services for these Missourians. 

Children make up nearly half of MO HealthNet beneficiaries. Deep funding cuts could mean slashing services for kids or postpartum mothers during a time of increasing maternal mortality, especially for Black women.

Because MO HealthNet was expanded several years ago through a constitutional amendment, Missouri lawmakers are required to replace lost federal funding. This revenue would have to come from new taxes or other parts of the state budget, reducing funding for education, public safety, and other essential services.

Federal cuts shift funding responsibility and the tough decisions to the state level, resulting in more Missourians without health insurance and making it tougher for rural hospitals and other health care providers to keep their doors open. Jobs and economic development, both inside and outside the health care system, would fade away.

Medicaid is not perfect. No health insurance program is. But deep indiscriminate cuts do nothing to lower costs or make care more accessible to Missouri families. To ensure that Missourians don’t get hurt, reforms must be done carefully and should not be rushed.

 

Missouri Foundation for Health -- Many Missourians Confused About Legality of Birth Control

by the Missouri Foundation for Health

There is considerable confusion about the legality of birth control in Missouri and many are worried about future access, according to a new survey of state residents. One in four (25%) Missourians do not believe or do not know that birth control pills — the most used form of contraception in the U.S. — are legal in the state. More than half (53%) do not believe or do not know that emergency contraception is legal, and four in 10 (40%) do not believe or do not know that IUDs are legal.

In addition, many in Missouri are concerned about the future availability of birth control. Fully half of survey respondents (50%) — including 44% of Republicans, 48% of Independents, and 66% of Democrats — are concerned that elected officials in Missouri will enact laws that restrict people from getting the birth control method they want.

The survey of 1,000 Missouri residents was conducted as part of the Missouri-based The Right Time initiative. Through this effort, health centers across the state are improving access to contraception by providing free or low-cost birth control in 34 locations. The Right Time provides training, assistance, and funding to expand access to the full range of contraceptive methods. The initiative is focused on offering patients same-day access to all methods of birth control, and has resources that make it easier for people in Missouri, including those who are uninsured or underinsured, to receive quality contraceptive services.

“The fallout from the Supreme Court’s Dobbs ruling on abortion has had expected and unexpected consequences,” said Michelle Trupiano, Executive Director of Missouri Family Health Council. “One unexpected result is that health centers across the state report that many patients are confused about the legality of birth control because of the June 2022 decision. The message is simple: Abortion is banned in Missouri; birth control is not.”

Other survey findings include:

72% of respondents — including 74% of Republicans, 85% of Democrats, and 87% of Independents — think the Missouri state legislature should pass policies that make birth control more affordable and accessible.

More believe that elected officials in Missouri are not supportive of birth control (36%) than those who believe legislators are supportive (26%). 

84% of respondents — including 82% of Republicans, 90% of Democrats, and 85% of Independents — support people aged 18-35 having access to all methods of birth control.   

More say they do not know how to get birth control online (48%) than those that say they are aware of online ordering (39%).  

The Right Time is improving information about, and access to, quality contraceptive services by reducing costs and improving access and knowledge. TheRightTime.org provides residents of Missouri with access to free and low-cost birth control, trustworthy information on birth control, and video testimonials about services and contraceptive methods.

“Our initiative is based on the simple belief that everyone should have the opportunity to pursue the future they want, including if, when, and under what circumstances to get pregnant,” said Kathleen Holmes, Vice President of Strategic Initiatives at Missouri Foundation for Health. “Removing barriers to quality contraceptive information and care is foundational to The Right Time effort. The polling released today makes clear that correcting misperceptions about the legality of birth control is both important and urgent.”

Missouri running out of time to decide on expanding Medicaid

Linda Spence is a 63-year-old full-time student at University of Missouri-Kansas City. After losing her job as a Program Director on the campus of UMKC, she has no health insurance because she does not qualify for Medicaid.
After the US Supreme Court ruled it unconstitutional for the federal government to force states into expanding their Medicaid coverage, Missouri now has a choice of whether or not to expand Medicaid for people like Linda Spence.
The Federal government will pay 100 percent of the financial burden imposed by Medicaid expansion for the first three years, but starting after the initial grace period, Missouri would start to become responsible for some of the cost. Starting in 2017, Missouri would be responsible for five percent of the cost in 2017 and 10 percent starting in 2022, according to state officials and advocacy groups.
Spence said she takes advantage of a discount at Truman Hospital for people with lower incomes. She said not many people know about this discount, and people who want it must apply for it. Spence also said without this discount, she would have no way of obtaining any kind of regular health care. She also said that not having insurance can affect the quality of health care she is able to receive.
"If I were able to qualify for something like Medicaid, granted I would have to qualify for it, but at least I would know it was something a little bit more guaranteed. I might have access to other physicians other than going through Truman. Maybe I would be able to choose my own doctor, for example. Go to specialists of my choosing, instead of just specialist that are available," said Spence.
A major concern legislators have with expansion is that it could take away a lot of funding from other areas of the budget, namely education.
"When you're looking at increases of potentially 100 or 200 million dollars that you have to find because of expansion, there is only one place where there is a pot of money big enough to take that, and that is public education," said Senate Appropriations Chair Kurt Schaefer, R-Columbia.
Schaefer said that there is no way around public education funding taking a hit with the Medicaid expansion, and if the true cost, is too detrimental to education then he would not be in favor of expansion.
Sen. Rob Schaaf, R-St. Joseph, thinks Missouri would have to pull funds from a diverse group of areas to fund expansion.
"I know from my experience as a legislator, that anytime one program absorbs up a bunch of resources, they try to spread the pain around everywhere else. So it isn't just education, every other program would suffer," Schaaf said.
Schaaf said Missouri does not have an obligation to use tax dollars to give able-bodied adults health care.
"We already take care of kids, and we take care of the disabled, and we take care of the elderly. These people are able-bodied, and it would be wrong for us to give them free health care and put them on Medicaid, and expect other working adults to pay for them," Schaaf, a licensed physician,  said.
For a single parent with one child to receive Medicaid under the current coverage in Missouri, their annual income would need to be less than $2,809.00, according to the Missouri Foundation for Health. The new program, should it be implemented in Missouri, would allow anyone at 133 percent of the federal poverty line to receive Medicaid. That covers a higher percentage of the poverty line than is currently afforded to people

Foundation Releases Annual Update on Missouri Medicaid

Missouri Foundation for Health (MFH) has released 2011 Missouri Medicaid Basics, an annual publication providing a straightforward, factual overview of the Missouri Medicaid program, now called MO HealthNet.

The publication is intended as a resource for the public, care providers and community leaders, and anyone seeking a clearer understanding of the MO HealthNet system.

Produced by MFH’s health policy staff, Missouri Medicaid Basics provides a clear framework for the state’s Medicaid program in three subject areas:

· MO HealthNet-eligible populations.

· Programs and services for MO HealthNet recipients.

· Funding sources for MO HealthNet (state, federal, and other).

The publication offers an explanation of MO HealthNet using a variety of easy-to-understand graphics and tables. New to the 2011 edition is a collection of graphics on
MO HealthNet enrollment growth by eligibility group and region.

There is updated information exploring the relationship between MO HealthNet enrollment and downturns in the state and national economies. This year’s version also highlights the impact of federal health reform on Medicaid.

2011 Missouri Medicaid Basics can be downloaded free of charge at http://www.mffh.org/mm/files/MedicaidBasics2011.pdf. Limited free print copies also are available; contact Chris Raborn at 314.345.5576 or craborn@mffh.org.

Established in 2000, MFH is the largest nongovernmental funder of community health activities in Missouri. MFH is in its eighth year of grantmaking, having issued more than
$410 million in grants and awards to date. It is dedicated to improving the health of unserved and underserved residents in 84 Missouri counties and the City of St. Louis.