The fate of the sole abortion clinic in Missouri has been placed in a new set of hands.

Three days after the Missouri Health Department denied the St. Louis Planned Parenthood’s application for a permit to perform abortions, a judge ruled Monday that the clinic must take its case to the Administrative Hearing Commission.

The independent state agency considers appeals and other petitions from the public and private sectors and is made up of four commissioners — one of whom could soon decide whether Missouri becomes the first state in more than 40 years without access to abortion.

In his decision, Circuit Judge Michael Stelzer wrote that he “has no authority to intercede in this matter until there has been a final decision by the AHC.”

The judge’s ruling also extended an earlier order that allowed Planned Parenthood to continue performing abortions, even after the state let its license lapse at the end of May. That preliminary injunction expires Friday at 5 p.m., giving the clinic four days to argue that the board should overturn the health department’s decision or at least further delay the license expiration.

The arguments on either side

Planned Parenthood’s physicians said they will continue performing abortions as long as they’re allowed, and they accused the state of carrying out an antiabortion political agenda.

“The terrifying reality is that access is hanging on by a thread with a narrowing timeline,” Colleen McNicholas, an OB/GYN at the clinic, said in a statement. “The truth is, if the Administrative Hearing Commission does not act by Friday, abortion access in the state of Missouri will be gone. This creates uncertainty for the patients we serve.”

The health department declined to comment on Monday’s ruling, but its director, Randall Williams, has said his agency denied the clinic’s application because it has corrected only four of the 30 deficiencies that officials identified during an annual inspection.

He again cited concerns over multiple “failed abortions,” which required additional procedures, and a patient who suffered life-threatening complications. The incidents have been central to the state’s case against Planned Parenthood.

The commission

Of the commission’s four members, three were appointed by former governor Jay Nixon (D). Early this month, Gov. Mike Parson (R) appointed the fourth, a former judge who was once publicly disciplined for supporting an antiabortion organization, the Associated Press reported. That commissioner, Philip Prewitt, told the outlet he would consider recusing himself if called to work the case.

The commissioners don’t hear cases or cast votes as a panel. Instead, cases are assigned to individual members. The Administrative Hearing Commission did not respond to a request for comment and has not indicated when it would make a ruling.

What happens next?

If Planned Parenthood’s appeal is successful, the clinic will be one step closer to securing a renewed license. If the commission denies the appeal, Missouri would become the first state since 1974 — the year after the Supreme Court decision in Roe v. Wade legalized abortion nationwide — with no operating abortion clinics.

But the organization has said, whatever the outcome, it will continue battling to stay open.

“This isn’t over,” Leana Wen, president of Planned Parenthood, said on Twitter. “We must continue to sound the alarm because we are in a state of emergency for women’s health in America — and we at Planned Parenthood will continue to fight in the courts and beyond to protect access to abortion care for all Missourians.”

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