On October 3, 2025, the debate over abortion rights in the United States intensified, as Missouri Secretary of State Denny Hoskins submitted a revised version of ballot language for a proposed abortion ban. This move came after a Cole County judge, Daniel Green, ruled that Hoskins’ initial attempt was "insufficient and unfair" because it failed to make clear that a current constitutional amendment—one that codified abortion rights in Missouri—would be repealed if the new measure passed. The revised language now explicitly states the amendment would "repeal Article I, section 36, approved in 2024; allow abortions for medical emergencies, fetal anomalies, rape, and incest," as reported by local Missouri outlets.
This proposed amendment, drafted by Republican lawmakers, is set to appear before Missouri voters in November 2026. It arrives two years after Missourians voted to enshrine the right to reproductive health care, including abortion up until fetal viability, in the state constitution. The upcoming ballot measure would roll back those protections, but with some exceptions: abortions would be permitted in cases of medical emergencies, fetal anomalies, rape, and incest—though only up to 12 weeks of gestation in the latter two scenarios. The new language does not specify how survivors of rape or incest would need to prove their circumstance to qualify for an abortion, leaving a critical question unanswered for now.
Judge Green’s intervention underscores the high stakes and intense scrutiny surrounding ballot language in abortion-related measures. In his October 1, 2025 ruling, Green emphasized that voters must be clearly informed that the proposal would undo a recent, voter-approved amendment. Hoskins, under a new state law enacted in 2025, now has three attempts to submit ballot language that the court finds satisfactory. Should he fail, Green himself will rewrite the language. As it stands, the latest summary swaps the word “amend” for “repeal,” highlighting the direct impact on existing constitutional protections.
The ballot summary also includes other contentious provisions: it would guarantee women's medical care for emergencies, ectopic pregnancies, and miscarriages; ensure women's safety during abortions; require parental consent for minors; and prohibit sex-change procedures for children. A "yes" vote, Hoskins wrote, would guarantee women's medical care under specific scenarios and ban gender-affirming health care for minors. A "no" vote would "limit abortion" to specific scenarios, as outlined in the official statement.
Before the 2024 amendment, Missouri had one of the strictest abortion regimes in the country, banning nearly all abortions except in medical emergencies. The new proposed ban would slightly expand access by permitting abortions for survivors of rape or incest up to 12 weeks gestation, but its overall effect would be to sharply curtail the rights Missourians only recently secured.
This legal battle in Missouri is emblematic of a much larger national struggle unfolding since the Supreme Court’s Dobbs v. Jackson decision in 2022, which overturned Roe v. Wade and returned the authority to regulate abortion to the states. According to research from the Abortion Attitudes Project, most Americans reject the use of the criminal justice system to police abortion care. Since Dobbs, more than half of U.S. states have passed laws that dramatically restrict and criminalize abortion, imposing penalties that range from fines to prison time—not only for healthcare providers but, in some cases, for people who assist abortion seekers.
Despite this legal trend, the Abortion Attitudes Project’s surveys over the past eight years reveal a striking disconnect between lawmakers and the public. “Most people do not endorse harsh penalties for pregnant people or healthcare providers,” the project reports. Even among those who believe abortion should be illegal, many draw the line at incarceration or criminal punishment, especially for pregnant people. In a 2020 national survey of 2,489 participants, the most common responses for punishment were "no punishment," "therapy/education," or "fines" for the pregnant person, and "no punishment," "fines," or loss of license for the provider. Support for jail or prison time was relatively low, even in states with strict abortion laws.
Recent events have only heightened concerns over the future of abortion access—particularly medication abortion. In Louisiana, an arrest warrant was issued for a California doctor accused of mailing abortion pills to the state, which had already shuttered all Planned Parenthood operations. That doctor is also facing a federal lawsuit in Texas for sending abortion pills to a woman there. Texas lawmakers, meanwhile, have approved a bill allowing private citizens to sue abortion pill providers, further escalating the risks for both providers and those seeking care.
On the federal level, Health and Human Services Secretary Robert F. Kennedy Jr. has ordered the Food and Drug Administration to investigate the safety of the abortion drug mifepristone, despite widespread expert consensus that the medication is safe. “Medication abortion has been available in the United States for 25 years, and it's available in the U.S. through the first 10 weeks of pregnancy,” Usha Ranji, Associate Director of Women’s Health Policy at KFF, told reporters. She noted that earlier abortions are safer, and delays caused by legal obstacles can endanger patients. “The threats of criminal liability and civil liability... can have a really chilling effect on clinicians because many already operate under pretty restricted circumstances,” Ranji added.
Research by KFF found that nearly two-thirds of women, and a similar proportion of OBGYNs, are concerned about the impact of abortion restrictions on women’s safety. These worries are not theoretical: delays in care or fear of prosecution can have real, sometimes tragic, consequences for patients in need of emergency medical attention.
The punitive legal climate surrounding abortion is not new, but its resurgence post-Dobbs is notable for how sharply it diverges from public sentiment. Decades of criminological research show that when people view laws as unjust, they are less likely to comply with them, and the legitimacy of legal institutions can be eroded. The Abortion Attitudes Project argues that current punitive abortion laws “risk undermining public trust in the legal system and do not align with public sentiment.” Even those who object to abortion on moral grounds often distinguish between legal disapproval and criminalization, with many expressing discomfort at the idea of jailing pregnant people or their doctors.
As Missouri prepares for its 2026 referendum—and as other states continue to refine, restrict, or defend abortion rights—the disconnect between law and public opinion remains a central tension in American democracy. The coming months and years will test whether lawmakers choose to heed the nuanced, often compassionate views of their constituents, or press forward with punitive measures that most Americans appear reluctant to endorse. For now, the battle over abortion remains as contentious, complicated, and consequential as ever.
