Hours after the Missouri Senate's vote, the state House has followed suit by approving a compromise bill on insurance coverage for contraception, abortion and sterilization that had been crafted earlier.

Employers could not be required to provide insurance coverage for abortion, contraception or sterilization if such coverage violated their religious or ethical beliefs.  No employees could be required to pay for such coverage in a group plan, if they held similar objections.

Gone are many of the provisions passed by the House on Wednesday – including an amendment to allow pharmacies to decline to stock any drug or medical device.

State Sen. John Lamping, R-Ladue, said the conference report largely reverts to his original bill that passed the state Senate overwhelmingly in late March.

(Start of update) Friday's final vote was 29-5 in the Senate and 105-33 in the House. The Senate vote is a veto-proof majority, but the House vote falls four votes short. (End of update)

Even so, opponents say the bill conflicts with the federal Affordable Care Act, the health-insurance overhaul now before the U.S. Supreme Court.

The federal act requires that no-cost contraceptive coverage be available through most group health plans or through insurers. Religious institutions, such as churches, would be exempted, but religious-affiliated institutions such as universities would not.

During the brief state Senate debate, Sen. Jolie Justus, D-Kansas City, said representatives for insurance companies were in the Capitol lobbying against the bill, contending that the measure will set up a situation where "they'll be in trouble with the feds if they do one thing, and they'll be in trouble with the state if they do another."

Lamping said the bill represented a good compromise in which the rights of religious-affiliated institutions, and any employers and employees with religious or ethical objections, would be protected.

Debate in House

(Start of update) In the House, the chief sponsor -- state Rep. Sandy Crawford, R-Buffalo -- said she was disappointed that so many provisions had been dropped but that she was willing to back the final version to get at least some protections passed for those who oppose such coverage.

State Rep. Genise Montecillo, D-St. Louis, contended that the bill was "a slippery slope" that could lead to employers seeking to drop other types of medical coverage that they find objectionable. "If everybody takes stuff out piecemeal, what sort of coverage would we have left?" she asked. (End of update)

The compromise, obtained by the Beacon, also includes language that states no employer, employee, health plan or health-care provider “shall be discriminated against by any governmental entity, public official or entity acting in a governmental capacity for failing to obtain or provide coverage’’ for such procedures because of their beliefs.

It's now up to Gov. Jay Nixon to decide whether to sign or veto the measure or allow it to become law without his signature.

Justus said the administration objected to parts of the bill, including its definition of "sterilization." The administration wants to make sure that all medically necessary sterilizations, such as hysterectomies, are not blocked from coverage under the bill, she said.

Backers of the bill say that sterilization for reasons unrelated to reproduction will not be affected.

(Start of update) The House debate got heated when state Rep. Stacey Newman, D-Richmond Heights, objected to the fact that the legislation dealt solely with women's reproductive issues. 

State Rep. John McCaherty, R-High Ridge, shouted, "The same rhetoric is being spilled. It's always about 'their choice,' 'their freedom.' People of faith have their rights as well!"(End of update)

Reason for compromise

Lamping told the Senate that the bill doesn't affect availability of abortions, contraceptions or sterilization procedures -- just who pays for them.

Lamping told the Beacon in an interview that he wasn’t taking a stand on the various amendments added by the House, but that those provisions needed “much debate and much discussion’’ in the Senate. 

Trying to get the Senate to vote swiftly in favor of a drastically altered bill, with little time left before adjournment, would likely kill the whole measure, he said.

The excised House provisions also included language to allow medical workers to decline to participate in any way in any action related to contraception or sterilization, if they opposed it.  Missouri law already allows medical professionals to decline to participate in abortions.

Some House members have long sought to get the “conscience clause’’ expanded to include, at minimum, certain types of contraception that some believe cause early-term abortions. Also sought by some conservatives, including some House leaders, has been the provision that would have given pharmacies freedom to stock what medicines they wish and to decline to fill certain prescriptions.

The compromise version does include language that stipulates that the Missouri attorney general can sue in federal or state court if it appears that the bill's provisions regarding coverage for contraception, abortion or sterilization have been violated.