Planned Parenthood sues Missouri social services agency over restricted Medicaid funds

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(Missouri Independent) – Planned Parenthood filed a lawsuit Thursday against Missouri’s Department of Social Services, alleging the agency unlawfully plans to restrict Medicaid payments to the provider.

A March 4 notice sent to Planned Parenthood of St. Louis Region cites a supplemental budget bill lawmakers passed last month that bars abortion providers or their affiliates from being reimbursed through the state’s Medicaid program. As a result, DSS contends it lacks appropriation authority and that Planned Parenthood is “ineligible for reimbursement,” a copy of the notice reads.  

Any claims for reimbursement will be suspended after 5 p.m Friday.

The lawsuit, filed in Cole County Circuit Court, alleges the budget bill is unconstitutional and the state cannot suspend Planned Parenthood from the state’s Medicaid program.

It also argues DSS is violating 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.

The state’s Medicaid program is prohibited from paying for abortions, except in the instances of rape, incest or to save the mother’s life. Planned Parenthood provides Medicaid patients with other reproductive health services, like STI screenings and contraceptives.

“The Medicaid law is clear, and Missouri is in desperate need of providers committed to seeing everyone who needs them,” Emily Wales, interim president and CEO of Planned Parenthood Great Plains, said in a statement. “Planned Parenthood is just that: A provider whose doors are open.”

The lawsuit is filed on behalf of Planned Parenthood of the St. Louis Region, Comprehensive Health of Planned Parenthood Great Plains and Planned Parenthood Great Plains — who each received claims suspension letters. It names various DSS officials as defendants, including Acting Director Robert Knodell and MO HealthNet Division Director Todd Richardson. 

Knodell declined to comment on the lawsuit Thursday.

Last month, Gov. Mike Parson signed a supplemental budget bill that blocks Planned Parenthood from receiving payments through the state’s Medicaid program.

It includes a “$0” line item toward abortion providers and their affiliates — a new tactic that anti-abortion advocates hope will survive court challenges.

In 2020, the Missouri Supreme Court struck down language in a 2018 budget bill that excluded abortion providers or their affiliates from receiving Medicaid reimbursements, calling it a “naked attempt” to legislate through a budget bill.

Sen. Dan Hegeman, R-Cosby and chair of the Senate Appropriations Committee, said last week he “fully intends” to insert similar language into the fiscal year 2023 budget bill as well.

The DSS notice sent to Planned Parenthood stipulates that the provider may appeal the decision with the administrative hearing commission. But in its lawsuit, Planned Parenthood argues doing so would be futile, because the commission cannot issue a declaratory judgment or determine the constitutionality of state statutes.

Other states have already restricted Planned Parenthood from their Medicaid programs, like Arkansas, and last year a U.S. Circuit Court of Appeals ruled that Planned Parenthood could be kicked off of Texas’ Medicaid program. Democratic lawmakers in Texas have asked the federal government to intervene.

Planned Parenthood said it will also launch a petition calling on the federal Centers for Medicare and Medicaid Services to take action and ensure federal laws are enforced.

Yamelsie Rodríguez, president and CEO of Planned Parenthood of the St. Louis Region and Southwest Missouri, said in a statement Thursday that Planned Parenthood will continue to serve Medicaid patients at no cost while the lawsuit is ongoing.

“That is our unbreakable commitment to the thousands of Medicaid patients who rely on us for life-saving health care,” Rodríguez said.

Lawmakers’ restriction of Medicaid payments from going to Planned Parenthood is one of many renewed attempts to bar public funds from going to abortion providers and their affiliates.

Last year, lawmakers used an essential tax on hospitals, nursing homes, and pharmacies, known as the federal reimbursement allowance (FRA), as leverage to attempt to restrict taxpayer dollars from going toward Planned Parenthood.

While the effort ultimately failed, lawmakers have once again filed bills that aim to bar abortion providers or their affiliates from participating in the state’s Medicaid program or from receiving public benefits more broadly.

In Missouri, only one facility currently remains where abortions are performed — Reproductive Health Services, affiliated with Planned Parenthood in St. Louis.

Reproductive rights advocates have argued lawmakers’ attempts to restrict funding from going to Planned Parenthood target access to reproductive health care as a whole, while anti-abortion advocates have said they don’t want taxpayer dollars to indirectly subsidize abortion providers.

The Missouri Family Health Council Inc. (MFHC) administers federal family planning dollars to clinics across the state, and in 2021 MFHC-funded sites provided family planning services to over 44,200 patients. More than half of those patients were served by Planned Parenthood, Michelle Trupiano, MFHC’s executive director, previously said.

Last week legislation that has bipartisan support and would extend health care coverage for low-income women from 60 days after giving birth to a full year was withdrawn amid debate over attempts by Sen. Bob Onder, R-Lake St. Louis, to attach language that would bar abortion providers and their affiliates from the state’s Medicaid program.

Onder said the bill was an ideal vehicle because it touched on the Medicaid program, and said he wasn’t sure he believed the language included in the supplemental budget would withstand legal challenges.

The state health department has also applied to oversee federal family planning dollars, a move reproductive rights advocates fear would cut off funding to providers, like Planned Parenthood. 

Meanwhile, on Tuesday the state health department argued in court it should not have to pay the roughly $146,000 in legal fees Planned Parenthood amassed defending itself in the state’s failed attempt to deny Planned Parenthood’s St. Louis clinic a license.

The Independent’s Rudi Keller contributed to this story. 

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Tessa Weinberg

Tessa Weinberg covers education, health care, and the legislature. She previously covered the Missouri statehouse for The Kansas City Star and The Columbia Missourian, where her reporting into social media use by the governor prompted an investigation by the Attorney General’s office. She most recently covered state government in Texas for The Fort Worth Star-Telegram.

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