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Defunding Planned Parenthood Could Violate Medicaid Laws

Defunding Planned Parenthood Could Violate Medicaid Laws

August 3, 2015 — An effort by congressional lawmakers who oppose abortion rights to defund Planned Parenthood could violate Medicaid laws, Politico reports (Pradhan, Politico, 8/3).

Background

The Senate on Monday is scheduled to hold a procedural vote on legislation that would defund Planned Parenthood.

Further, conservative lawmakers in the House and Senate have voiced opposition against any government spending measures that allocate funding for Planned Parenthood, which could lead to another government shutdown dispute in the fall. Congress faces a Sept. 30 deadline to pass spending legislation to keep the government in operation (Women's Health Policy Report, 7/31).

Medicaid Law Protects Beneficiaries' Provider Choice

Congress controls funding allocation, and could "stop the flow" of Title X money if any defunding measure were approved, though it faces both political and administrative obstacles, Politico reports. Additionally, Congress could face legal challenges if it tries to cut off Planned Parenthood's Medicaid funding because Medicaid law protects beneficiaries' rights to select their health care providers, as long as the providers accept Medicaid.

According to Politico, efforts to cut off Medicaid funding -- such as those in Arizona, Indiana, North Carolina and Tennessee -- have been blocked by the courts. Susan Fogel, director of reproductive health for the National Health Law Program, said, "The cases where states have tried to take away Medicaid funding from Planned Parenthood have all failed in one way or another."

She added that stripping the organization's Medicaid funding likely would be ruled discriminatory. "Shutting down family planning clinics because of taking away money from Planned Parenthood only hurts the individuals who need those services," she said, adding, "I'm sure that there would be immediate litigation to stop it in the courts."

Meanwhile, Cindy Mann -- a former CMS deputy administrator and currently an attorney at Manatt, Phelps & Phillips -- said protections on beneficiaries' provider choice are particularly strong regarding family planning services. She said, "That's been an important provision to ensure access and allow women to make their own decisions about who to go to."

According to Planned Parenthood, state and federal Medicaid funding accounts for roughly 75% of the organization's government-based funding (Politico, 8/3).

Defunding Planned Parenthood Could Lead to Gap in Women's Health Services

Meanwhile, the Senate bill designed to redirect Planned Parenthood funding to other women's health providers, if successful, would not necessarily cover the resulting gap in women's health services, the National Journal reports.

According to National Journal, Planned Parenthood provides preventive health services -- such as cancer screenings, family planning, testing and treatment for sexually transmitted infections, and well-woman exams -- for roughly 2.7 million people annually. Alina Salganicoff, vice president and director of women's health policy at the Kaiser Family Foundation, said, "Community health centers provide really critically important services to low-income women in this country, but it's not clear all of them are equipped to provide the full range of sexual and reproductive services that women need."

For example, only 19% of community health centers report that their largest clinics prescribe and dispense all types of contraceptive methods on-site. According to National Journal, many community health centers give patients referrals for certain contraceptive methods.

Further, Planned Parenthood clinics currently account for 10% of all federally funded health centers in the U.S. and serve 36% of total clients who seek care at facilities that receive public funding. Dawn Laguens, executive vice president of the Planned Parenthood Action Fund, said, "More than half of Planned Parenthood's nonprofit health centers are in rural or medically underserved areas, and millions rely on us each year for care. If this bill went into effect, blocking our health centers from serving patients who rely on publicly funded programs for health care, millions of people would struggle to access quality reproductive health care -- period" (Owens, National Journal, 8/2).

More States Call for Investigations into Planned Parenthood

In other related news, more states have called for investigations into Planned Parenthood following the videos' release, CQ News reports (Evans, CQ News, 7/31).

Last week, an Indiana investigation into Planned Parenthood clinics in the state cleared the organization of any wrongdoing in how fetal tissue is handled (Women's Health Policy Report, 7/31). In addition, Massachusetts has closed an investigation of the group, which also cleared Planned Parenthood of any wrongdoing.

Nonetheless, according to CQ News, other states have announced similar investigations, including Arizona, Florida, Georgia, Louisiana, Missouri, Ohio, Kansas, South Carolina, Tennessee and Texas (CQ News, 7/31).

Washington Post Calls on Politicians To Stop 'Vendetta Against Planned Parenthood'

A Washington Post editorial calls on conservative lawmakers to stop "the vendetta against Planned Parenthood."

According to the Post, the videos showcase "distorted" information "to paint an inaccurate and unfair picture of a health organization that provides valuable services to women -- as well as to demonize research that leads to important medical advances -- [which] doesn't matter to antiabortion activists. Or, sadly, to the politicians who pander to them." The Post continues, "None of the videos released shows anything illegal and, in fact, the full footage of Planned Parenthood executives meeting with people presumed to be buyers for a human biologics company include repeated assertions that clinics are not selling tissue but only seeking permitted reimbursement costs for expenses."

According to the Post, "No federal money is used by Planned Parenthood to provide abortions except in some rare exceptions. So cutting off government funds, mostly through Medicaid and grants, would only hurt the thousands of people, most of them low-income women, who each day depend upon Planned Parenthood for birth control, cancer screenings, testing and treatment for sexually transmitted infections and other health services." Further, the Post notes, "Given that many of the clinics are in medically underserved areas, it's a myth ... that other providers can fill the gap" if Planned Parenthood is defunded and closing Planned Parenthood clinics only would "make it harder for many women to obtain birth control."

The editorial urges lawmakers who support abortion rights "and others [to] continue to stand up for Planned Parenthood and the women whose health depends upon its services" ("The Post's View," Washington Post, 7/31).