Missouri's Republican lawmakers are once again trying to block federal health care dollars from going to the state's Planned Parenthood clinics, this time weeks after the Missouri Supreme Court thwarted a previous attempt to end that funding.

The Republican-led House on Wednesday gave initial approval to a bill that would bar Medicaid funding from going to Planned Parenthood, which is already banned by state law from providing abortions in almost all circumstances.

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Republican lawmakers argued no public funding should go to the organization, which offers abortions in other states.

"When you do business with an entity like a Planned Parenthood, you’re ultimately subsidizing those abortion services, even if they are in other states," bill sponsor Rep. Cody Smith said during Wednesday floor debate.

House Democrats said the ban will limit low-income residents’ choice in where they go for health care such as cancer screenings and birth control. In some areas of the state, Democratic Rep. Patty Lewis said it could mean blocking access to those services altogether.

"In the state of Missouri, defunding Planned Parenthood services is defunding affordable access for our constituents," Lewis said.

The measure needs another vote of approval in the House before it can move to the Senate.

Medicaid Abortion Missouri

A Missouri and American flag fly outside Planned Parenthood in St. Louis, June 24, 2022. On Wednesday, Feb. 28, 2024, the Republican-led Missouri House gave initial approval to a bill that would bar Medicaid funding from going to Planned Parenthoods, which are already banned by state law from providing abortions in almost all circumstances. (AP Photo/Jeff Roberson)

A similar effort to block Medicaid funding from Planned Parenthood stalled in the GOP-led Senate earlier this month after a Democrat attempted to amend the bill to allow exceptions for rape and incest under the state’s current ban on almost all abortions. Missouri in 2022 banned abortion except in cases of medical emergencies.

Lawmakers previously were able to stop money from going to Planned Parenthood in the 2019 fiscal year by forgoing some federal funding to avoid requirements that the clinics be reimbursed if low-income patients go there for birth control, cancer screenings and other preventative care. Missouri instead used state money to pay for those services.

But the Missouri Supreme Court in 2020 ruled lawmakers violated the state constitution by making the policy change through the state budget instead of a separate bill, forcing the state to reimburse Planned Parenthood for health care provided to Medicaid patients.

Republican lawmakers are acting with increased urgency this year after the Missouri Supreme Court earlier this month rejected yet another attempt by Republican state officials to block taxpayer dollars from going to Planned Parenthood, citing a failure in the state’s legal appeal.

The high court’s decision upheld a ruling by a trial judge, who found that a 2022 funding bill violated the state constitution. The Supreme Court said Republican Attorney General Andrew Bailey’s office failed to appeal a claim that the law violated equal protection rights, and it thus must stand.

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Also pending is an effort to amend the state constitution to protect abortion rights. Supporters now are working to gather more than 170,000 voter signatures by May 5 to get on the November ballot.