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Uneven legal representation for Missouri parents leaves kids languishing in foster care

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missouriindependent.com – Clara Bates – 2025-05-12 05:55:00


Megan Knight’s struggle to reunite with her children highlights Missouri’s fragmented foster care legal system, marked by inconsistent access to parental attorneys. Despite completing required programs and proving mental health stability, Knight faced court without legal representation after her initial lawyer withdrew. Missouri’s decentralized system leaves many parents unrepresented or stuck with overworked, underpaid lawyers, varying by county. Parents often don’t know their right to counsel, and appointed attorneys lack standardized training or support. Families in poverty suffer the most, risking prolonged foster care stays or loss of parental rights. Advocates call for statewide reforms to ensure consistent, quality legal defense to protect family integrity.

by Clara Bates, Missouri Independent
May 12, 2025

The chair labeled “mother’s attorney” sat empty in the front row of the Christian County courtroom, and Megan Knight felt her stomach turn.

While state workers and the judge discussed, rapid fire, the fate of her family, she prepared to make her case.

She completed the parenting course the state required, and enrolled in more classes — on topics ranging from healthy relationships to helping kids through divorce — which she thought would show initiative. She gathered character references from professionals who had worked closely with her family for years. She continued seeing a therapist and psychiatrist who helped her recover from postpartum depression.

Staff from the state child welfare agency and juvenile office wanted her to go to a different therapist of their choosing but had not provided her with a referral. 

Now, she was ready to explain the situation to the judge, with a thick folder of documentation to back up her account. She raised her hand. 

But the judge told her the docket was full and the hearing wasn’t the correct type for presenting new evidence, using legal terms that were unfamiliar to Knight. The judge heard only the state’s position — that Knight hadn’t completed her services as required — and sided with what the state workers had proposed, leaving the kids in foster care, before moving on to the next case.

Knight left court deflated and confused. 

It was August 2024, and Knight was without an attorney as she fought to reunite with her children — as she would be for months.

“I can’t tell you how nerve-wracking it is, that you have nobody on your side,” she said.

Missouri’s system for providing legal representation to families ensnared in the foster care system is highly decentralized, relying on county-level funding and operating with little state oversight, a months-long investigation by The Independent found.

The result: some parents, like Knight, go without representation, while those who do get assigned an attorney often find them too overworked and underpaid to provide meaningful advocacy.

Knight’s three oldest children were taken from her in April 2023 on allegations of physical abuse, emotional abuse and neglect that Missouri’s child welfare agency, called Children’s Division, later found to be unsubstantiated. The following year she gave birth to another child, who was removed on an allegation of sexual abuse, which was also found to be unsubstantiated.

For years, she has worked with children. And in a development Knight finds confounding, last fall she passed an extensive background check run through the Department of Social Services — which oversees Children’s Division — allowing her to work with foster children at a residential care facility. 

“I’m good enough to work with other people’s kids, other foster kids within the court system who are a ward of the state,” she said, “but I’m not allowed to have my own.”

Knight’s case has dragged on, and she fears that the longer her kids remain in state custody, the lower their chances of reunification become. 

“I don’t have anybody on my side,” she said. “I’m literally just left alone to basically fend for myself, which is impossible when it comes to these kinds of cases.” 

The attorney initially appointed by the court to represent Knight withdrew and her subsequent request for a replacement was denied by the court. In September, she picked up a second job to hire an attorney, who she has so far paid over $6,000. She works overtime whenever she can. She’s not sure how much longer she’ll be able to afford to keep paying him, at $375 an hour.

Megan Knight and her four children in 2024 (photo submitted).

The U.S. Constitution guarantees the right to representation for those facing criminal charges. But there is no such federal right in civil court, where foster care cases unfold. The consequences — family separation — can feel as severe as incarceration.

The outcome can depend on where you live, even within a state. 

In some Missouri counties, more than 80% of foster care cases involving a biological parent list no attorney for the parent, while in other counties, that rate is under 10%. That’s according to data produced by the Office of State Courts Administrator — which provides administrative, business and technology support to Missouri courts — in response to a request from The Independent. 

State law grants judges in Missouri more discretion than in most other states when deciding whether to appoint counsel for indigent parents. Once appointed, quality and pay vary widely. 

A survey of Missouri’s 46 judicial circuits by The Independent shows some counties pay parents’ attorneys as little as $25 per hearing, and some attorneys carry hundreds of cases at a time. Attorneys told The Independent in some counties parent representation is considered pro bono work because the pay is so low. 

There is no required specialized training in the state to be a parents’ attorney, though there is required training for similar positions, such as guardians ad litem — attorneys tasked with representing foster kids’ best interests. There are no state Supreme Court-adopted standards of practice. Parents’ attorneys in most counties in the state are solo practitioners who agree to take on some of these cases in addition to the rest of their caseload. They don’t always have expertise in this complex area of law. 

No counties had, as of last month, spent federal funding that has been available for parent representation since 2019, a spokesperson for the Department of Social Services told The Independent — and just one county is in the process of doing so.

Courts reached by The Independent all said it’s routine to appoint an attorney for indigent parents, when requested. Parents who spoke to The Independent about their struggles navigating the process, and advocates who work with them, said it isn’t always so straightforward. 

Some parents said they didn’t know they could qualify, were rejected even though they were too poor to afford a lawyer out-of-pocket, or received representation only for the initial part of their case. Others said they were appointed attorneys who were impossible to reach outside of court and didn’t seem to be advocating for them.

“Each individual county and circuit gets to do it however they want,” said Claire Terrebonne, who was a parents’ attorney in Kansas City for over a decade, and has pushed for systemic reform in the state. “It was really when I looked outward that I became so shocked about how we do things here.” 

Allison Green, chief legal officer for the National Association of Counsel for Children, which advocates for robust family defense, said access to quality counsel for parents and kids is “absolutely critical” for a healthy and functional child welfare system.

“A common misconception is that foster care is only a social service discipline,” she said, “when actually foster care implicates the civil rights of children and parents and families.”

The system should function, Green said, to make sure that families “are only separated when it’s absolutely necessary to do so, and that they are provided the services that federal and state law requires in order to reunify them.” 

Several states in recent years, including Oklahoma, have moved toward centralized systems of family representation, similar to statewide public defender offices, to ensure consistent, high-quality representation that is uniformly funded. 

This issue has gotten scant attention from the Missouri Legislature, though this year one section of a wide-ranging foster care bill takes steps toward understanding the system, by establishing a commission to study parents’ and children’s legal representation throughout the state, and directing the commission to recommend practice standards and training requirements. That bill passed — close to none of the discussion during hearings dealt with parents’ representation — and awaits Gov. Mike Kehoe’s signature.

Clark Peters, a professor of social work at the University of Missouri-Columbia whose research specializes in foster care, said the stakes of high-quality parent counsel are enormous.

“We sometimes lose sight: a day without your child is tremendously difficult for parents and for children,” he said. “To go months?  I mean, it’s kind of unthinkable…We’re talking about child well-being and family integrity. What is more important than that?” 

‘By yourself, it’s impossible’ 

Amanda Garretson’s wall is decorated with art created by her younger daughter, who was in Children’s Division custody for over a year (Clara Bates/Missouri Independent).

States vary widely in how they organize their systems of family defense and the rights afforded to accused parents, as there is no federal right to an attorney for parents in child welfare proceedings. Most states have a statutory right to counsel. Missouri is among a few that has a statutory right with discretion, meaning judges can decide on a case-by-case basis. They must determine that appointment is necessary for a “full and fair hearing,” as well as determine that the parent desires counsel and is indigent. 

There’s little consistency in how judges determine whether a parent can afford an attorney on their own, or whether they need one. 

If a case reaches the termination of parental rights stage, state law requires a lawyer be provided, and the state, rather than county, pays for it. But by that point, advocates say, it can be too late: If the parent hasn’t been zealously represented all along, with a lawyer doing things like helping document all the efforts they’ve taken to reunify, and connecting them to resources, they won’t have a strong defense. 

Federal law says that if the child has been in foster care for 15 out of the most recent 22 months, the state generally should file a petition to terminate parental rights. 

Kathleen DuBois, who represented parents for over two decades as an attorney with the legal aid organization in St. Louis, said the threat of termination of parental rights means an attorney should be appointed at the outset and the state should foot the bill.

“To me, the case is a termination from the time that the child is taken,” she said. “So you should treat it as a termination of rights from the very beginning and pay for counsel for the parent from the very beginning without putting all these conditions on it.” 

DuBois remembers a client who had previously been represented by a court-appointed attorney with so many cases that he had no idea who the client even was.

“That’s pretty shameless to tell somebody that you can’t even figure out who they are,” she said. “…But people are acting like this is just an ordinary process, and it’s not. It’s the civil death penalty.”

DuBois said as an attorney, she would help parents connect to necessary services, some of which Children’s Division may not have known about, and explain to her clients the importance of complying. Parents’ attorneys help translate the parents’ efforts to the court and the court’s requirements to parents; they also help explain and protect parents’ rights, and advocate for the placement and visitation wishes of the parent.

A statewide, uniform infrastructure with robust defense, she said, “would certainly get better justice.” 

Amanda Garretson plays at home with her 3-year-old in Springfield (Clara Bates/Missouri Independent).

Amanda Garretson, a mother of two daughters in Springfield who has grappled with addiction, homelessness and mental illness, experienced the difference having an attorney can make. 

Her older daughter was taken into state custody in late 2019, after Garretson attempted suicide.

“I wasn’t harming my child. I was there because I was depressed,” she said. 

She assumed because she couldn’t afford an attorney, she wouldn’t get one, and doesn’t remember ever being told otherwise. Garretson missed the first court hearing, but at meetings thereafter, she doesn’t remember anyone on her support team, including caseworkers, ever telling her she would qualify or what the role of a lawyer would be in these complex arrangements. She felt overwhelmed by all the new phrases — from family support team meeting, to jurisdictional hearing and shelter hearing — and “scared to death” with no one to explain them.

She said she felt the state workers were treating her as “guilty until proven innocent.”

She knew she needed counseling and that with the right support she could recover. Instead, she said the process of trying to get her daughter back, and a sense no one was fighting for her, caused her to “fall hard into addiction” and become homeless.

In 2021, her daughter was adopted and Garretson’s parental rights were involuntarily terminated. Garretson still hopes one day to reunite with her.

“I didn’t have anyone on my side, and I just, I didn’t know what was going on,” she said. “I didn’t know the procedures. They’re like, ‘Well, you should have researched it.’ When you’re that far into a trauma mode, you’re grieving your child like they’re dead.” 

“I know 100% that it would have been a whole lot different if I had any ounce of support on my side,” she said.

She contrasts that experience with the case of her younger daughter, who was born in 2021. Her daughter was taken into Children’s Division custody for over a year on allegations of drug use that Garretson denied, after they were in a car accident.

That time, Garretson was given a court-appointed attorney who helped explain what was happening, and she said fought hard for her. Still, as the case stretched on, she decided to pay $2,500 she scraped together for a private lawyer. She thought the judge would take her more seriously and close the case more quickly, and she worried if the Children’s Division case stayed open, it would affect a separate, family court case.

Her Children’s Division case was finally closed earlier this year and she has her younger daughter back.

“By yourself,” she said, “it’s impossible.” 

Families in poverty are more likely to have their kids taken into foster care; they’re also least likely to be able to afford to pay high-quality attorneys out-of-pocket.

“What happens if your children were with strangers for months? And what would you do? Of course, you would hire an attorney,” said Peters, the University of Missouri professor. “And the fact is that poor litigants, residents of Missouri who can’t afford it, they should get those. Not just a warm body, but somebody who’s going to fight to make sure that their child and that family gets to the other side of this legal matter in the best shape they can.”

A high rate of removal, lingering in the foster care system

Missouri has long taken kids into foster care at a rate higher than average and kept them there for more time. 

There were 11,085 kids in foster care as of March, down from a peak of 14,265 kids in 2021. The entry rate is still higher than the national average.

Only 44% of Missouri foster children were reunited with their families within a year of entering state care, according to the most recent data in the agency’s budget, covering fiscal year 2024. 

The federal benchmark is 75%.

Baylee Watts, spokesperson for the Department of Social Services, wrote by email that the agency “is committed, and all team members are expected, to actively support reunification efforts when safe and appropriate, in alignment with both statutory mandates and best practices in child welfare.”

Studies show high-quality representation for families improves the speed of kids going home with no evidence of an increased rate of maltreatment or reentry into foster care. There are also potential cost savings.

Advocates say robust legal representation could allow the state Children’s Division to devote its limited resources to the most severe cases.

Richard Wexler, director of the advocacy group National Coalition for Child Welfare Reform, said there is a “deep contempt for families” in the system by those who assume horror stories about child abuse are the norm, which is “nothing like what most of these families are like.”

Over half of substantiated cases in Missouri involve neglect, a category often conflated with conditions of poverty, including housing instability and lack of supervision due to an absence of child care.

“The fact that some families are literally defenseless is a travesty. They are facing consequences vastly more serious than many criminal offenses when they have a constitutional right to a lawyer,” Wexler said.

System for lawyers varies by county

Daniel Kuehnel outside his home in Arnold in February (Clara Bates/Missouri Independent).

Daniel Kuehnel, a father in Arnold whose two kids were taken into foster care in 2022, said he had no idea he could have qualified for a free lawyer. He was accused of physical abuse and emotional abuse, which he denied, amid a contentious divorce and custody battle. Earlier this year, Children’s Division closed the case and he has full custody of his son. He sees his daughter, who lives with a relative, each weekend.

He didn’t attend the first court date — an emergency placement hearing — because he was “freaking out all night,” terrified, he said, after finding out the state had removed his kids the afternoon prior. He had left the house to pick up his son from his bus and run into two police officers and two investigators, he said, and found it impossible to prepare for court less than 24 hours later.

He would likely have qualified for a court-appointed lawyer as indigent because he was receiving food assistance through the Supplemental Nutrition Assistance Program, or SNAP. He was working in maintenance at the time and is now living on veterans’ disability payments.

“I didn’t know a lot of this stuff,” he said. “Nobody informed me of nothing.”

For the first month, he didn’t have an attorney and felt “hopeless.” 

His now-spouse, whom he met a few months after the case opened, was willing to lend him money to pay for an attorney, which Kuehnel said made all the difference in his case. 

He ultimately paid around $40,000 to three attorneys, trying to keep his family together. 

Daniel Kuehnel and his 10 year old son, who was in Children’s Division custody until earlier this year (photo submitted).

His final attorney really fought for him, he said. The state closed his case earlier this year.

“In the system, it’s about money,” he said, “and if you got the money, that case is going to get handled.” 

In Jefferson County, where Kuehnel lives, there was no attorney listed for parents in 46% of foster care cases from 2020 to 2024, according to data the Office of State Courts Administrator produced in response to a records request from The Independent. 

Jefferson County’s juvenile office didn’t respond to several requests for comment. But court officials in other counties told The Independent there could be a variety of reasons for parents not having an attorney listed, ranging from the parent not wanting one because they don’t trust the system to a parent not engaging in the process at all. 

The issue of parents lacking counsel appears to be a problem throughout the state to varying degrees. In Christian and Greene counties, where Knight and Garretson live, state court data shows just single-digit rates of parents going without attorneys. The chief juvenile officer for Greene County, Bill Prince, said the court “makes every effort” to provide eligible parents with attorneys, including by offering the application for counsel as soon as the court makes contact with the parent, and inquiring about the issue at each hearing in which the parent appears without counsel.

The presiding judge of Christian County, Laura Johnson, wrote in an email to The Independent that it’s “highly unusual” for parents to proceed without an attorney. She said generally speaking that it’s unusual for a court-appointed attorney to withdraw and when it happens, it’s most often because the parent chose to end that relationship.

“If a parent chooses to ‘fire’ a court-appointed attorney, the court usually does not appoint another attorney for that parent,” Johnson wrote, but if the attorney withdraws for a reason “not within the parent’s control…then another attorney will be appointed.”

Knight, the mother who is trying to reunite with her children in Christian County, insisted she didn’t fire her attorney, though she said their relationship was strained because the two disagreed over whether Knight should have her providers and advocates come to the monthly case management meetings. Court records show the attorney filed a motion to withdraw from Knight’s case in July 2024, citing an “irreparable breakdown” of the attorney-client relationship.

‘No matter how hard I try’ 

Megan Knight, wearing a sweatshirt that says “mama,” in Springfield earlier this year (Clara Bates/Missouri Independent).

Knight said as the state continues to keep her kids in care, it’s the kids who suffer the consequences. She wishes earlier in her case, she could have conveyed to the judge all she’d wanted to — if she’d had a zealous court-appointed advocate.

Her four-year-old daughter has been moved seven times since she was taken into foster care in April 2022. Knight said she’s developed behavioral issues Knight attributes to the trauma of separation and being tossed around from home to home.

“When I was able to see her, she would always beg the caseworker, ‘Please, let me go home to my mom,’” she said.

Now, her daughter is in care with a foster family and Knight doesn’t know where in Missouri they are or who the family is. Two of her kids are in another stranger’s home. 

She’s losing sleep over her absent children and her hair is falling out. 

Johnson, the Christian County presiding judge, wrote in an email that she cannot comment on pending cases. But the reason cases would remain open, generally, after Children’s Division finds child abuse or neglect allegations to be unsubstantiated, is because the juvenile courts have an “independent statutory duty” to find a safe, nurturing and permanent placement for a child removed from their home, which requires hearings and sometimes treatment plans, she said. The juvenile court cannot return the child to their home until all statutory requirements are met, Johnson said.

The Department of Social Services can’t comment on specific cases, said Watts, the agency’s spokesperson. She said that although an investigation may conclude allegations of abuse are unsubstantiated, “and a person deemed eligible for employment, that does not resolve or override the juvenile court proceeding, the outcome of which is ultimately determined by the juvenile court judge.”

She added that sometimes additional concerns come to light after the investigation of the initial allegations, so the absence of substantiated findings “may not alleviate all of the concerns present in the foster care case.”

Knight requested a copy of her case file from the Department of Social Services last July, and still has not received it — which the agency in a message to Knight attributed to a backlog of requests.

Knight says the state continues portraying her as mentally unstable, though therapy notes and records from private social services groups Knight has worked with — the notes she wanted to convey to the judge that day last summer — provide a different picture. 

Knight’s children play together in 2022, the year before they were taken into foster care (photo submitted).

Her therapist last year wrote that Knight “has immense love for her kids and this is the reason she has fought this hard in this case.” Knight’s behavior leading up to when her kids were taken — which involved yelling at her baby and telling her parents she wanted to die —  was consistent with postpartum depression, she wrote.

The therapist said she was worried about “long-term trauma…for not only Megan but her children.” She recommended that reunification be the goal “due to mental health concerns being a primary cause of children’s removal, and current mental health of the client being observed as stable and appropriate for life circumstances.” 

A parent advocate from a nonprofit last year wrote to the court that despite “all of Megan’s efforts and her willingness to be transparent with the team, seek any services requested and show growth in setting healthy boundaries in her relationships,” her efforts to get her kids back continued to stall, and the state workers seemed intent on pursuing termination of her rights.

The Office of Child Advocate, the independent oversight arm for the Children’s Division, investigated Knight’s case and found “policy and procedure concerns” it conveyed to Children’s Division including the state workers’ “derogatory” comments about the family, according to a findings’ letter sent to Knight in January 2024.

“It would be best practice for all team members to be supportive of reunification,” the agency, which investigates complaints against the child welfare system, wrote. The agency added that it was “unclear what services or accommodations were being provided” to Knight to help with her documented mental health diagnoses including depression and anxiety.

A social worker through a nonprofit wrote in a report to the court last year that Knight will “continue to parent effectively, with ongoing mental health support following case closure.” 

Knight said those sources have been discounted in her case, even after her current lawyer was finally allowed to introduce them. She worries the case is too far gone.

While she attended therapy throughout most of the process, the state is requiring her to work with a therapist of their choosing. Knight has waited nine months to be assigned a state-approved therapist, and her caseworker told her in a text last month that they are still looking.

In February, Knight found out she is pregnant. When she told her caseworker, she said she was told the baby would likely be removed, too, due to her open case. 

“I’m just lost beyond words, really. It’s like, no matter what I do, no matter how hard I try, no matter how honest I am, it just gets thrown in my face,” Knight said. 

“Never in my life did I think I would be in this situation.” 

This article was produced as part of the USC Annenberg Center for Health Journalism’s National Fellowship.

Missouri Independent is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Missouri Independent maintains editorial independence. Contact Editor Jason Hancock for questions: info@missouriindependent.com.

The post Uneven legal representation for Missouri parents leaves kids languishing in foster care appeared first on missouriindependent.com



Note: The following A.I. based commentary is not part of the original article, reproduced above, but is offered in the hopes that it will promote greater media literacy and critical thinking, by making any potential bias more visible to the reader –Staff Editor.

Political Bias Rating: Center-Left

The article presents a critical view of Missouri’s foster care and legal representation system, highlighting significant issues such as inadequate representation for parents and systemic flaws in child welfare services. While the content focuses on individual cases and advocates for better support and fairness, particularly for parents in lower-income situations, it does so with a focus on reform and accountability. The tone emphasizes the struggles of disadvantaged families, which aligns with a more empathetic and reform-driven perspective, often associated with Center-Left or Left-Leaning viewpoints. The piece aims to expose flaws in the system without overtly promoting a partisan agenda but tends to support progressive changes to the legal system for family reunification and better legal access for parents. This suggests a Center-Left bias in its advocacy for social justice and governmental intervention in support of vulnerable families.

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Teen survives explosion, family speaks out

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www.youtube.com – FOX 2 St. Louis – 2025-08-26 22:30:20

SUMMARY: Eighteen-year-old Dante Anthony survived a devastating house explosion in North St. Louis County on August 25th, which left him with second- and third-degree burns covering 85% of his body. Trapped by collapsed debris and flames, Dante escaped through the fire but remains hospitalized in critical condition, sedated and enduring intense pain. His family lost their home and belongings, including keepsakes. In response, his uncle Terence has organized a GoFundMe and a benefit concert at Granville Theater on August 31st to support Dante’s recovery. Despite the trauma, Dante’s athletic spirit and community support are helping his long road to healing and future plans in sales.

Eighteen-year-old Dontea Hardy’s life was changed in a matter of seconds when an explosion ripped through his family’s home on Aug. 25.

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Who was Hunter Simoncic? KCK officer killed by driver in overnight police chase

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fox4kc.com – Olivia Johnson – 2025-08-26 13:32:00

SUMMARY: Kansas City, Kansas Police Officer Hunter Simoncic, 26, was tragically killed early Tuesday when struck by a driver during a police chase. A Galesburg native, he graduated from the police academy in November 2023 and held degrees in sociology and forensic science. Known for his dedication to youth, Simoncic volunteered reading to students and worked as a juvenile detention shift supervisor. Kansas City officials honored his sacrifice, emphasizing his community impact. Dennis Edward Mitchell III has been arrested and faces multiple charges related to Simoncic’s death. Donations to support Simoncic’s family can be made through the KCK Fraternal Order of Police Memorial Fund.

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As Republicans spar over IVF, some turn to obscure MAHA-backed alternative

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missouriindependent.com – Anna Claire Vollers – 2025-08-26 07:00:00


Republican support for in vitro fertilization (IVF) is fracturing amid ideological divides. While some GOP lawmakers in states like Alabama, Tennessee, and Georgia have passed laws protecting IVF access, others oppose it due to beliefs that embryos are human lives, equating IVF embryo discarding to abortion. President Trump initially championed IVF access and insurance coverage but later cut federal IVF tracking programs and abandoned coverage mandates. Meanwhile, conservative groups promote “restorative reproductive medicine” (RRM) as a pro-life infertility alternative, despite medical criticism of its efficacy. States like Arkansas have mandated RRM insurance coverage, reflecting growing political tension over IVF within the Republican Party.

by Anna Claire Vollers, Missouri Independent
August 26, 2025

Republican support for in vitro fertilization, after surging in the wake of a 2024 Alabama Supreme Court decision that threatened the procedure, may be splintering as President Donald Trump retreats from his IVF promises and more far-right voices gain ground.

Earlier this year, conservatives in the Tennessee House staged an eleventh-hour skirmish over an IVF protection bill introduced by two of their Republican colleagues. The bill eventually passed, becoming one of the first in the nation to explicitly protect access to IVF. But some lawmakers who voted for it have signaled their willingness to revisit the issue.

In Georgia, a Republican-sponsored bill to codify the right to IVF into law sailed through the legislature, even as fellow conservative lawmakers introduced their own anti-abortion bill that opponents warned would undermine the IVF protections in the new law.

In statehouses around the nation, IVF has emerged as a dividing line running through the Republican Party. Particularly in states where abortion is banned, lawmakers who unite under the “pro-life” banner disagree over whether the popular treatment gives life or destroys it.

People who believe embryos are children oppose IVF because it can involve the discarding of some embryos, which they say is akin to abortion.

“The popularity of IVF creates a dilemma for Republican politicians who have had anti-choice organizations as a key part of their constituency for their whole careers,” said Sean Tipton, chief advocacy and policy officer at the American Society for Reproductive Medicine.

After the Alabama Supreme Court ruled last year that embryos are people, fertility clinics around the state temporarily halted their services, sparking nationwide outrage.

Republicans and Democrats rushed to pledge their support for fertility treatments such as IVF and announce their plans to protect it.

On the campaign trail last year, Trump promised to make insurers cover IVF so that it would be free for patients. After taking office, he signed an executive order giving White House officials 90 days to assemble a list of policy recommendations on protecting IVF access and reducing costs.

In March, he called himself “the fertilization president.”

But a week later, his administration eliminated the team of experts at the federal Centers for Disease Control and Prevention responsible for tracking IVF outcomes across the United States. The team had, among other things, operated a database allowing consumers to look up an individual fertility clinic’s success rates. Earlier this month, The Washington Post reported that the White House doesn’t plan to require insurers to cover IVF services, though administration officials told the newspaper that IVF access remains a priority.

Meanwhile, conservative groups that oppose abortion have begun pushing an obscure alternative treatment for infertility called “restorative reproductive medicine,” or RRM. Advocates have urged the White House and federal and state legislators to back RRM, which is based on the idea that the underlying causes of infertility can be treated through lifestyle changes and improving a person’s overall health.

Arkansas recently became the first to pass a pro-RRM law. Others might follow suit in upcoming legislative sessions.

Cole Muzio, founder and president of the Georgia conservative Christian nonprofit Frontline Policy Council, said he doesn’t expect to see legislators try to ban IVF outright, despite preemptive efforts by legislators in his state and others to protect it.

“Republicans are intrinsically pro-family, and the idea of supporting those who want to have a family is a conservative, noble, positive thing,” he said.

“At the same time, IVF discards an overwhelming number of human lives. We’ve got a lot of work to do to educate people.”

IVF pushback grows louder

This spring, the Tennessee bill protecting IVF passed unanimously in the state Senate. But by the time it hit the House floor in April, many of its Republican supporters sat silently while a few of their GOP colleagues tried to derail it.

The bill’s sponsor, Republican state Rep. Iris Rudder, told the Tennessee Lookout that she hadn’t expected disagreement over the bill to “mushroom the way it did.”

It eventually passed. But 11 Tennessee House Republicans sent a letter to GOP Gov. Bill Lee urging him to veto it and calling it “a Trojan horse that could potentially undermine Tennessee’s strong and righteous stance on the protection of innocent human life.”

Lee signed it in April.

The following day, Tennessee Senate Majority Leader Jack Johnson — who voted for the bill and said he supports IVF and contraceptives — told constituents during a legislative forum that he’d had “lots of conversations” about it and expects the legislature to revisit the issue again in the next session.

“I think we’ll be back next year to take another stab at it,” he said.

In Georgia, the state’s most powerful Republicans made a bill to codify the right to IVF a major priority this year. It was signed into law in May.

“Thanks to a lot of bipartisan support and hard work, Georgians who want to grow their families will never have to worry about whether or not they can access this vital treatment,” the bill’s sponsor, Republican state Rep. Lehman Franklin, posted to X after it passed through the legislature. Franklin and his wife conceived through IVF, a story he has shared publicly as he promoted the measure.

“At the end of the day, being pro-family means being pro-IVF,” he wrote.

Muzio, of the Frontline Policy Council, believes the IVF debate represents not so much a split in the Republican Party as it does a lack of education about what the treatment really means to people who believe human life begins as soon as an egg is fertilized.

“Hopefully you’ll see [legislation] put in place that either backs different fertility treatments that are more pro-life or guardrails put in place to restrict the discarding of human life for the purposes of IVF,” he said.

For conservatives who see IVF as akin to abortion, restorative reproductive medicine has emerged politically as an option for addressing infertility without explicitly supporting IVF, which remains overwhelmingly popular among Americans.

Out of obscurity

RRM was a relatively obscure idea until anti-abortion groups such as The Heritage Foundation began elevating it over the past year as an alternative to IVF. With RRM, a practitioner might help patients analyze their diet, chart their menstrual cycle to look for conditions that can impact fertility, or treat reproductive disorders like endometriosis or thyroid dysfunction.

Supporters argue that a more holistic approach is a better way to treat infertility, and that RRM methods are much less expensive than IVF, which can cost tens of thousands of dollars.

But RRM has been criticized in mainstream medical circles. The American College of Obstetricians and Gynecologists calls RRM a “nonmedical approach” and an “unproven concept” that can delay time to pregnancy and expose patients to needless and painful surgical interventions, such as procedures to treat polycystic ovarian syndrome. It says the approach overwhelmingly puts the onus on women, ignoring that infertility causes are just as common in men.

Some experts worry that patients spending months or years on RRM treatments will lose precious time when IVF could have helped them get pregnant.

And OB-GYNs warn RRM is closely tied to the anti-abortion “personhood” movement, which attempts to grant fertilized eggs the same legal status as people — potentially leading to a loss of rights for pregnant patients and more severe restrictions on birth control and other reproductive health care.

Tipton, of the American Society for Reproductive Medicine, believes RRM is more “ideology” than medical practice.

“[RRM] got legs thanks to the work of really influential right-wing and anti-choice groups,” he said. “They put their considerable resources into asking, ‘How do we blunt the momentum IVF is getting without saying we’re opposed to IVF?’”

But as RRM gains mainstream attention, it’s also found supporters in the Make America Healthy Again (MAHA) movement promoted by Robert F. Kennedy Jr., secretary of the U.S. Department of Health and Human Services. Some consumers remain skeptical of the fertility industry, where some clinics have ties to private equity firms and other large corporations.

In March, Arkansas Republican state Rep. Alyssa Brown told fellow legislators that RRM “prioritizes women’s health over the profits of Big Pharma and Big Fertility.”

First in the nation

Brown sponsored a first-of-its-kind bill in Arkansas — which passed in April and was signed into law — that requires state insurance companies to cover RRM treatments.

Brown promised during a hearing that it wouldn’t limit access to IVF. Arkansas was one of the earliest states, in 1991, to require insurance companies to cover IVF.

A similar bill with the same title, the RESTORE Act, was introduced in Congress again this year, after failing last year. It includes recommendations from The Heritage Foundation and the conservative, anti-abortion Ethics and Public Policy Center.

Arkansas’ new law also requires programs funded through Title X, which provides birth control and other reproductive care to low-income families, to use fertility awareness-based methods, mirroring a similar effort at the federal level. Under Kennedy, HHS has indicated plans to use Title X funding to open an “infertility training center.” Part of the center’s focus, according to its grant announcement, is to “educate on the root causes of infertility and the broad range of holistic infertility treatments” available to patients.

Meanwhile, state legislators around the country this year attempted to require health insurance to cover IVF, including in Montana, North Carolina, Rhode Island, Vermont and West Virginia.

Nevada’s Democratic-controlled legislature passed a bill in June establishing the right to fertility treatments, including IVF, but it was swiftly vetoed by Republican Gov. Joe Lombardo.

In May, Virginia Republican Gov. Glenn Youngkin signed a bill into law requiring a state insurance commission to consider coverage for procedures like IVF, a move that sets the stage for requiring health insurance companies to cover it. Before signing, Youngkin tried to insert a provision allowing private plans to opt out of coverage for religious or ethical beliefs, but the legislature rejected the change.

Although he signed the measure, Youngkin said his exemption idea needed to be taken up if the state eventually mandates coverage of fertility treatments.

Stateline is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Stateline maintains editorial independence. Contact Editor Scott S. Greenberger for questions: info@stateline.org.

Missouri Independent is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Missouri Independent maintains editorial independence. Contact Editor Jason Hancock for questions: info@missouriindependent.com.

The post As Republicans spar over IVF, some turn to obscure MAHA-backed alternative appeared first on missouriindependent.com



Note: The following A.I. based commentary is not part of the original article, reproduced above, but is offered in the hopes that it will promote greater media literacy and critical thinking, by making any potential bias more visible to the reader –Staff Editor.

Political Bias Rating: Center-Left

This content presents a thorough overview of the political landscape surrounding in vitro fertilization (IVF) policies, especially focusing on divisions within the Republican Party between traditional conservative pro-family stances and far-right anti-abortion groups opposed to IVF. The article highlights policy debates, legislative actions, and the contrasting views on IVF and alternative treatments like restorative reproductive medicine (RRM), while also acknowledging bipartisan support and the medical community’s perspective. The nuanced coverage, inclusion of multiple viewpoints, and emphasis on political implications and controversies, especially criticism of far-right anti-abortion influences, indicates a center-left bias that is generally supportive of reproductive rights and skeptical of more extreme conservative positions.

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