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Missouri push to defund Planned Parenthood clinics continues in appeal

From left: Kendyl Underwood, a 20-year-old St. Louis University student studying nursing, demonstrates in support of abortion rights on Friday, June 24, 2022, outside the Planned Parenthood of the St. Louis Region and Southwest Missouri. “The only thing we can do is push back,” Underwood said. “It’s not democracy for [the Supreme Court] to pass this and we have to make that heard.”
Brian Munoz
/
St. Louis Public Radio
From left: Kendyl Underwood, a 20-year-old St. Louis University student studying nursing, demonstrates in support of abortion rights in June 2022 outside the Planned Parenthood of the St. Louis Region and Southwest Missouri in the Central West End. “The only thing we can do is push back,” Underwood said regarding the overturning of Roe v. Wade. Missouri Attorney General Andrew Bailey's office filed a brief arguing a trial court decision that forbid the state from zeroing out the Medicaid funding for Planned Parenthood services should be reversed.

Missouri’s Supreme Court will once again determine whether the state has the authority to restrict public funds from going to Planned Parenthood, after the attorney general formally filed its appeal last week of a December ruling that deemed the effort unconstitutional.

After the state legislature voted to block Planned Parenthood from receiving Medicaid reimbursements last year, Planned Parenthood sued. In December, Cole County Circuit Judge Jon Beetem concluded it was unconstitutional for the state to deny access to funds available to other health care providers.

The attorney general’s office announced its intention to appeal earlier this year, and last week filed the appeal on behalf of the Department of Social Services, which oversees Missouri’s Medicaid program.

It won’t be the first time the issue has reached Missouri’s highest court.

In 2020, the Missouri Supreme Court struck down language in a budget bill that excluded abortion providers or their affiliates from receiving Medicaid reimbursements, calling it a “naked attempt” to legislate through a budget bill. And the issue itself has been around for decades: Missouri lawmakers have been attempting to restrict public funds from going to Planned Parenthood since the mid-90s.

“The idea that the state legislature is required to fund Planned Parenthood is ridiculous,” Attorney General Andrew Bailey said in a statement Thursday to The Independent.

Yamelsie Rodríguez, president and CEO of Planned Parenthood of the St. Louis Region and Southwest Missouri, said her organization is confident “the Supreme Court will — yet again — reject this clear political attack on a trusted health care provider and affirm the lower court’s ruling in favor of Planned Parenthood.”

“Our elected leaders should stop playing games with their constituents’ health care and putting our patients’ health care access at risk,” Rodríguez added.

Funding for Planned Parenthood was once again zeroed out the budget earlier this year, and despite December’s ruling, Planned Parenthood has not been receiving Medicaid reimbursements.

Planned Parenthood and its defenders argue that legislative attempts to restrict the organization’s funding is a broader assault on access to reproductive health care as a whole. Meanwhile, anti-abortion advocates contend the state should not use taxpayer dollars to subsidize abortion providers.

Xavier Becerra, U.S. Secretary of Health and Human Services, speaks to the media about the 1-year anniversary of the Dobbs decision, which overturned the constitutional right to access an abortion, on Friday, June 23, 2023, at the Planned Parenthood of the St. Louis Region & Southwest Missouri’s clinic in the Central West End.
Brian Munoz
/
St. Louis Public Radio
Xavier Becerra, U.S. Secretary of Health and Human Services, speaks to the media about the 1-year anniversary of the Dobbs decision, which overturned the constitutional right to access an abortion, on June 23 at the Planned Parenthood of the St. Louis Region & Southwest Missouri’s clinic in the Central West End.

Missouri’s Medicaid program has long included a ban on state funding for abortions, with the exception of instances of rape, incest or to save the life of the mother. But after last year’s U.S. Supreme Court decision overturning the constitutional right to an abortion, Missouri’s trigger law went into effect banning abortion without any exceptions for rape or incest.

Lawmakers last year passed a supplemental budget bill that blocked Planned Parenthood from receiving payments through the state’s Medicaid program, which serves low-income and disabled Missourians. That prevented Medicaid reimbursements for the reproductive health services such as STI screenings, cancer screenings and contraceptives.

Planned Parenthood filed its lawsuit against Missouri’s Department of Social Services in March of last year arguing the state cannot deny Medicaid funding for the health services Planned Parenthood provides.

The lawsuit also argued the Department of Social Services was violating a state law that allows Medicaid patients to choose any qualified provider to receive services from, that there are sufficient funds to reimburse Planned Parenthood for its services and that the state is breaching Planned Parenthood’s provider agreements in Missouri’s Medicaid program, MO HealthNet.

In his December ruling, Beetem agreed with Planned Parenthood that efforts to “deny access to funds that are otherwise available to other MO HealthNet providers is ineffective and/or unconstitutional.”

The state’s appeal argues that Planned Parenthood should have first filed suit in the Missouri Administrative Hearing Commission, that Planned Parenthood lacked standing because it did not prove direct harm and that Medicaid contracts dictate that providers accept reduced payments when there is a funding deficiency.

“Here, the General Assembly exercised core legislative power to determine that some providers should receive more funds than others,” the attorney general’s office wrote in its appeal. “…After all, the entire purpose of the appropriations process is to prioritize funds.”

The state’s brief was filed last week. The attorneys for Planned Parenthood generally have 30 days from that date to respond.

This story was originally published by the Missouri Independent, part of the States Newsroom.

Clara Bates covers social services and poverty for The Missouri Independent.