Last week, Missouri passed a $27-billion-dollar budget, and of those funds, a grand total of zero dollars are going to Planned Parenthood because the organization provides abortion services.
Following the actions of 24 states that have sought to defund Planned Parenthood and make women's access to abortion care impossible, Missouri's 2017 budget stamps out federal funding to the health provider. The state rejected more than $8.3 million in federal Medicaid funding for family planning and reproductive health and instead allocated money from Missouri's general revenues for those services, according to the Associated Press. That money, Missouri's legislature made clear, cannot go to organizations that provide abortions.
In other words, the state spent millions of taxpayer dollars to block federal funding for Planned Parenthood. Critics say this is in apparent attempt to side-step a federal warning from the Centers for Medicare and Medicaid services (CMS), which implies that cutting Medicaid funding to Planned Parenthood—or any health organization that is certified to provide medical services—solely as a result of political targeting is against federal law. Under the Social Security Act, the letter states, Medicaid recipients have the right to obtain care "from any institution, agency, community pharmacy, or person, qualified to perform the service or services required... who undertakes to provide... such services." Therefore defunding a health clinic without evidence of wrongdoing "would not be in compliance with the free choice of provider requirement. If a state does not have evidence supporting its finding that a provider failed to meet a state standard, that provider remains 'qualified to furnish' Medicaid services."
The state of Missouri has no evidence to suggest the organization does not have a right to operate (though they're desperately trying to find some). While anti-abortion zealots would certainly like to eradicate abortion providers, the CMS tersely reminded state governments that they "may not deny qualification to family planning providers, or take other action against qualified family planning providers, that affects beneficiary access to those providers—whether individual providers, physician groups, outpatient clinics or hospitals—solely because they separately provide family planning services or the full range of legally permissible gynecological and obstetric care, including abortion services (not funded by federal Medicaid dollars, consistent with the federal prohibition), as part of their scope of practice."
However, Missouri's government believes that rejecting all Medicaid funding and replacing it with state revenue exempts the state from federal scrutiny, according to the AP report. (Notably, the 2017 budget also illustrates that since 2007, the state has increased the budget for their Alternatives to Abortion Program. Next year, the governor recommends allocating $3,658,561 to the program, which aims to convince "low-income pregnant women [to carry] their unborn child to term instead of having an abortion.")
According to Planned Parenthood, each year 50,000 Medicaid patients rely on Planned Parenthood's 13 clinics in Missouri. (Only one of these locations performs abortions, and it's the only abortion provider remaining in the state.) Keeping Planned Parenthood from accessing Medicaid funds means the clinics in the state will not be able to be federally reimbursed for accepting Medicaid patients. This would generally mean that Planned Parenthood would be forced to stop accepting patients on Medicaid once the budget takes effect in July. Sarah Felts, a spokesperson from the organization, told Broadly that until then, "Planned Parenthood in Missouri is a qualified Medicaid provider and is currently serving patients with Medicaid."
"It is too soon to tell exactly how this budget measure would affect Planned Parenthood health centers in Missouri," Felts continued. But she said that "Planned Parenthood's promise" is for "these doors stay open." Which is a good thing; other states, like Texas, that have barred federal funding from Planned Parenthood have seen disastrous public health effects, including a decline in contraception use. Despite anti-abortion lawmakers who argue that women can go to a number of other clinics for family planning, STD screenings, breast exams, and pap smears, Planned Parenthood plays an outsized role in providing reproductive health services to Medicaid enrollees.
"Planned Parenthood Advocates in Missouri condemns this effort to turn down $8 million in federal funds in order to skirt federal Medicaid law and prevent Planned Parenthood patients from getting state-funded preventive care," Felts said. "This is fiscally irresponsible and potentially damaging to the health of countless Missourians."