JEFFERSON CITY, Mo. (AP) — Missouri’s Republican-led Legislature on Wednesday passed a bill to ban Medicaid funding from going to Planned Parenthood, a move they have tried for years in a state where almost all abortions are banned.

The bill, approved 106-48 Wednesday in the House, aims to make it illegal for Missouri’s Medicaid program to reimburse Planned Parenthood for health care services to low-income patients, such as pap smears and cancer screenings.

Abortions are not covered by Medicaid, and almost all abortions are illegal in Missouri. But abortion opponents say Planned Parenthood should not receive any public funding because clinics in other states provide abortions.

“My rhetorical question is: Is Planned Parenthood sending monies from our state budget to other states to allow for women to have an abortion?” Republican Rep. Brian Seitz asked during Wednesday debate on the House floor. “Abortion is murder.”

House Democratic Minority Leader Crystal Quade in a statement described the bill as “an act of petty vengeance by Republicans against one of largest providers of women’s health care in Missouri.”

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Planned Parenthood cautioned that other reproductive health care providers that serve Medicaid patients in Missouri do not have the capacity to take on all of Planned Parenthood’s patients.

“Experts are clear: there are not enough other providers in the health care safety-net system to absorb Planned Parenthood’s patients,” the region’s Planned Parenthood said in a statement Wednesday. “At Planned Parenthood, we’ll continue to do everything we can to continue serving our patients — no matter what.”

Few states — Arkansas, Mississippi, and Texas, according to Planned Parenthood — have successfully blocked Medicaid funding for the organization.

A February state Supreme Court ruling found that Missouri lawmakers’ latest attempt at defunding Planned Parenthood was unconstitutional.

While past efforts to kick Planned Parenthood off Missouri’s Medicaid program have been struck down by courts, this year, GOP lawmakers are taking another approach and passing the ban as a policy bill in hopes of avoiding another legal showdown.

Some House Democrats predicted the latest defunding bill likely will be fruitless, too. They pointed to a pending constitutional amendment that could go before Missouri voters this fall and would restore abortion rights in the state.

The abortion-rights campaign needs to collect at least 172,000 voter signatures by May 5 to get on the ballot.

A spokesperson for Gov. Mike Parson on Wednesday did not immediately respond to an Associated Press request for comment on whether the Republican intends to sign the latest Planned Parenthood defunding bill. But his support is expected.