JEFFERSON CITY, Mo. (AP) — A Missouri appeals court panel ordered new wording Thursday for a ballot measure seeking to roll back abortion rights in the state, ruling that voters must be told the amendment would repeal “reproductive healthcare rights” they approved just one year ago.

The ruling marks the latest twist in a lengthy battle over Missouri’s abortion laws, which have fluctuated from restrictive to permissive since the U.S. Supreme Court ended a nationwide right to abortion in 2022 by overturning Roe v. Wade.

The Supreme Court ruling triggered a Missouri law to take effect banning most abortions. But abortion-rights activists gathered petition signatures to place an amendment on the 2024 ballot allowing most abortions, which narrowly won voter approval.

The Republican-led Legislature responded in May by placing a new amendment proposal on the ballot in 2026 that would repeal the prior one and instead allow abortions only for a medical emergency or fetal anomaly, or in cases of rape or incest up to 12 weeks of pregnancy. The amendment also would prohibit gender transition treatments for minors, which already are barred under state law.

A state judge in September struck down the ballot summary written by Republican lawmakers, deeming it insufficient and unfair. The judge later approved a revision written by Republican Secretary of State Denny Hoskins. But the appeals court said Thursday that Hoskins’ version “falsely implies” that the measure would create new guarantees of access to certain reproductive health care.

The appeals panel imposed new ballot wording stating the measure would “Repeal the 2024 voter-approved Amendment providing reproductive healthcare rights, including abortion through fetal viability,” while also listing the circumstances in which abortions would still be allowed.

Hoskins’ office declined to comment Thursday on the latest development. The attorney general’s office, which defended the ballot summary in court, did not immediately respond to a request for comment.

The American Civil Liberties Union, which helped bring the lawsuit, said the ruling recognizes the potential impact of the ballot measure.

“It is crucial that Missourians know they are being asked to end the protections for reproductive health care that we just passed in the last general election,” said Tori Schafer, director of policy and campaigns at the ACLU of Missouri.

Abortion-rights advocates prevailed on seven ballot measures across the U.S. and lost on three during the November 2024 elections. An abortion-rights amendment will be on the ballot next year in Nevada, and potentially also in Virginia.

David A. Lieb, The Associated Press