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Missouri voters on Tuesday resoundingly approved an amendment to overturn the state’s near-total abortion ban, making it the first state to do so in the wake of the U.S. Supreme Court’s 2022 ruling in Dobbs v. Jackson Women’s Health Organization, which eliminated federal constitutional protection of abortion. The passage of Amendment 3, which enshrines reproductive rights in the state constitution, signals the potential to begin restoring access to health care in a swath of the country that has become an abortion desert.
“The people of Missouri – be they Democrat, Republican, or independent – have resoundingly declared that they don’t want politicians involved in their private medical decisions,” said Rachel Sweet, campaign manager for Missourians for Constitutional Freedom, the umbrella organization for the Yes on 3 campaign.
Missouri was one of 10 states with abortion rights on the ballot this week. In Florida, voters narrowly rejected an amendment that would have restored abortion rights beyond the state’s current six-week ban — a prohibition on abortion that kicks in before nearly everyone knows they’re pregnant. The loss was a shining example of the power of minority rule: Florida’s Amendment 4 secured 57 percent of the vote, but failed because state law required a 60 percent vote to pass.
By late Tuesday night, measures to enshrine reproductive rights had easily passed in New York, Maryland, and Colorado and were winning by significant margins in Arizona. Meanwhile, Nebraska’s dueling measures — one that would ban abortion after the first trimester of pregnancy and one that would expand abortion rights far beyond the first trimester — were nearly tied, according to the New York Times. Measures in Montana and Nevada were still up in the air, while a measure to protect some abortion rights in South Dakota looked doomed to fail.
Missouri was the first state to officially outlaw abortion after the Dobbs decision, when then-Attorney General Eric Schmitt pulled the trigger on a 2019 law passed in anticipation of the overturning of Roe v. Wade. Missouri’s anti-abortion forces were gleeful, but the ban — which contains only a vague exception for medical emergencies and no protections for rape or incest survivors — almost immediately began wreaking havoc; some hospitals initially refused to dispense emergency contraceptives, worried that doing so would violate the ban, while others turned away people facing pregnancy emergencies.
Despite the ban’s draconian impact, conservative lawmakers and activists in the state claimed it was working just fine — under the ban, “women are safe in Missouri,” Cassidy Anderson with the Vote No on 3 campaign recently told Fox News digital — and fought tooth and nail to block Amendment 3 from ever appearing on the ballot. Those efforts began with the “Decline to Sign” campaign that sought to discourage voters from supporting a petition to get the measure on the ballot — including by claiming the petition drive was really a nefarious effort by “out-of-town strangers” angling to “collect your sensitive personal data for extremist groups.” Ultimately, nearly 400,000 people signed in favor of the putting the amendment on the ballot.
Secretary of State Jay Ashcroft played his part in the anti-amendment effort — first by penning an inflammatory ballot summary, ultimately rejected by the courts, claiming the proposed amendment would “allow for dangerous, unregulated, and unrestricted abortions” in the state. Later, Ashcroft attempted to decertify the measure — which would have yanked it from the ballot — a move that was also rejected by the courts.
Anti-abortion legislators and advocates mounted their own failed legal challenge in an effort to keep the amendment off the ballot.
The win for Amendment 3 also comes despite a last-minute push by groups campaigning against the measure. The Vote No on 3 political action committee received a seemingly much-needed, week-out $1 million cash infusion from the Concord Fund, a dark-money operation with strong ties to the conservative legal movement’s bespectacled, behind-the-curtain puppet master Leonard Leo. Even with the Leo-connected cash, the anti-amendment campaigns pulled a paltry sum in comparison to donations to Missourians for Constitutional Freedom, which was running the yes-on-3 campaign. Supporters of the amendment donated more than $30 million, dwarfing the roughly $3 million in donations made to Vote No on 3, according to filings with the Missouri Ethics Commission.
Spokespeople for the anti-amendment campaigns have described the consequences of approving the so-called Right to Reproductive Freedom Initiative in dire, if not unabashedly hyperbolic, terms. Among the favorite talking points is a claim that passing the amendment would necessarily topple the state’s ban on gender-affirming care for minors, which was signed into law in 2023. On Tuesday, signs invoking the amendment’s alleged power to rescind the anti-transgender legislation and urging a no-vote on the amendment popped up at polling places around Kansas City. “NO on 3,” one sign read. “NO TAX PAID CHILD SEX CHANGE SURGERY.”
“You would think in an initiative that is being advertised as a ‘women’s health care’ initiative … that it would say the word ‘woman’ somewhere in the ballot language, and it never says the word ‘woman,’” Anderson also told Fox News. “It refers to persons; it doesn’t define age, it doesn’t define sex, it doesn’t define anything.”
The measure is, on its face, expansive. It bars government infringement on a right to reproductive care and decision-making but allows for some state regulation of abortion after the point of fetal viability — a somewhat fluid concept, but generally the point at which a fetus can survive on its own, outside the womb and without extraordinary measures — but only as that is defined by health care providers on a case-specific basis.
Still, its practical impact will likely be determined through a series of legal challenges. For starters, advocates will have to sue, using the new constitutional language to challenge the abortion ban that is currently on the books. From there, the contours of the constitutional right would be further defined based on additional legal challenges to other statutory regulations covering abortion and reproductive health care. Similarly, any attempt to overturn the state’s ban on gender-affirming care would play out in the courts.
In other words, passage of the new constitutional amendment is just the first step on a long road to restoring real reproductive freedom in Missouri.
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