Democrat Lucas Kunce is trying to pin reproductive care restrictions on Sen. Josh Hawley (R-Mo.), betting it will boost his chances of unseating the incumbent in November.
In a recent ad campaign, Kunce accuses Hawley of jeopardizing reproductive care, including in vitro fertilization. Staring straight into the camera, with tears in her eyes, a Missouri mom identified only as Jessica recounts how she struggled for years to conceive.
"Now there are efforts to ban IVF, and Josh Hawley got them started," Jessica says. "I want Josh Hawley to look me in the eye and tell me that I can't have the child that I deserve."
Never mind that IVF is legal in Missouri, or that Hawley has said he supports limited access to abortion as a "pro-life" Republican. In key races across the country, Democrats are branding their Republican rivals as threats to women's health after a broad erosion of reproductive rights since the Supreme Court struck down Roe v. Wade, including near-total state abortion bans, efforts to restrict medication abortion, and a court ruling that limited IVF in Alabama.
On top of the messaging campaigns, Democrats hope ballot measures to guarantee abortion rights in as many as 13 states — including Missouri, Arizona, and Florida — will help boost turnout in their favor.
The issue puts the GOP on the defensive, said J. Miles Coleman, an election analyst at the University of Virginia.
"I don't really think Republicans have found a great way to respond to it yet," he said.
Abortion is such a salient issue in Arizona, for example, that election analysts say a U.S. House seat occupied by Republican Juan Ciscomani is now a toss-up.
Hawley appears in less peril, for now. He holds a wide lead in polls, though Kunce outraised him in the most recent quarter, raking in $2.25 million in donations compared with the incumbent's $846,000, according to campaign finance reports. Still, Hawley's war chest is more than twice the size of Kunce's.
Kunce, a Marine veteran and antitrust advocate, said he likes his odds.
"I just don’t think we’re gonna lose," he told KFF Health News. "Missourians want freedom and the ability to control their own lives."
Hawley's campaign declined to comment. He has backed a federal ban on abortion after 15 weeks and has said he supports exceptions for rape and incest and to protect the lives of pregnant women. Missouri's state ban is near total, with no exceptions for rape or incest.
"This is Josh Hawley's life’s mission. It’s his family’s business," Kunce said, a nod to Erin Morrow Hawley, the senator's wife, a lawyer who argued before the Supreme Court in March on behalf of activists who sought to limit access to the abortion pill mifepristone.
State abortion rights have won out everywhere they've been on the ballot since the end of Roe in 2022, including in Republican-led Kentucky and Ohio.
An abortion rights ballot initiative is also expected in Montana, where a Republican challenge to Democrat Jon Tester could decide control of the Senate.
On a late-April Saturday along historic Main Street in St. Charles, Missouri, people holding makeshift clipboards fashioned from yard signs from past elections invited locals strolling brick sidewalks to sign a petition to get the initiative on Missouri ballots. Nearby, diners enjoyed lunch on a patio tucked under a canopy of trees in this affluent St. Louis suburb.
Missouri was the first state to ban abortion after Roe fell; it is outlawed except in "cases of medical emergency." The measure would add the right to abortion to the state constitution.
Larry Bax, 65, of St. Charles County, said he votes Republican most of the time but signed the ballot measure petition along with his wife, Debbie Bax, 66.
"We were never single-issue voters. Never in our life," he said. "This has made us single-issue because this is so wrong."
They won't vote for Hawley this fall, they said, but are unsure if they'll support the Democratic nominee.
Jim Seidel, 64, who lives in Wright City, 50 miles west of St. Louis, also signed the petition. He said he believes Missourians deserve the opportunity to vote on the issue.
"I've been a Republican all my life until just recently," Seidel said. "It's just gone really wacky."
He plans to vote for Kunce in November if he wins the Democratic primary in August, as seems likely. Seidel previously voted for a few Democrats, including Bill Clinton and Claire McCaskill, whom Hawley unseated as senator six years ago.
"Most of the time," he added, Hawley is "strongly in the wrong camp."
Over about two hours in conservative St. Charles, KFF Health News observed only one person actively declining to sign the petition. The woman told the volunteers she and her family opposed abortion rights and quickly walked away. The Catholic Church has discouraged voters from signing. At St. Joseph Parish in a nearby suburb, for example, a sign flashed: "Decline to Sign Reproductive Health Petition!"
The ballot measure organizers turned in more than twice the required number of signatures May 3, though, and now await certification from the secretary of state's office.
Larry Bax's concern goes beyond abortion and the ballot measure in Missouri. He worries about more governmental limits on reproductive care, such as on IVF or birth control. "How much further can that reach extend?" he said. Kunce is banking on enough voters feeling like Bax and Seidel to get an upset similar to the one that occurred in 2012 for the same seat — also over abortion. McCaskill defeated Republican Todd Akin that year, largely because of his infamous response when asked about abortion: "If it's a legitimate rape, the female body has ways to try to shut that whole thing down."
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 This article was reprinted from khn.org, a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF - the independent source for health policy research, polling, and journalism.
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