In Missouri, patients under anesthesia or who are unconscious can be legally examined by doctors or doctors-in-training without the patient knowing about the exam. The Missouri House of Representatives has passed a public health package that would ban prostate, anal and pelvic exams without consent.

There would be some exceptions, including if the patient or person authorized to make health care decisions for the patient gives approval and the exam is necessary for diagnostic or treatment purposes, or a court orders the exam for evidence.

State Rep. Hannah Kelly, R-Mountain Grove, is the bill handler in the House.

“This is about making sure that disclosure is a part of the conversation and education is empowerment,” said Kelly.

State Rep. Maggie Nurrenbern, D-Kansas City, supports the bill.

“I think this is one of the most important pieces of legislation for public health that has come before this body,” says Nurrenburn.

Other items in the bill would:

*Require health insurance companies to cover the full cost of follow-up exams used to diagnose breast cancer if an initial mammogram finds potential problems

*Provide full coverage to women while pregnant and for one year after the end of pregnancy, instead of the current 60 days post-pregnancy

**Allow patients under 18 to have Do Not Resuscitate orders issued on their behalf by a parent or legal guardian or by a juvenile or family court

*Prevent immediate loss of government benefits, like food stamps, when participants get a pay raise or consider a job promotion. The amendment would instead reduce those benefits proportionate to any income increases

*Create a program to provide forgivable loans to education expenses for health care, mental health, and public health professionals

Senate Bill 106, sponsored by Sen. Lauren Arthur, D-Kansas City, goes back to the Senate for that chamber to decide whether it supports the changes.

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