Texas Kicks Planned Parenthood Out of Medicaid

At a certain point, perhaps after they defund the roads and utility lines leading to its clinics, Texas politicians and policymakers are going to run out of ammunition in their jihad against Planned Parenthood. But that hasn't happened yet. Last week, Texas' Health and Human Services Commission promulgated rules banning abortion providers — as well as any organization whose name kinda sounds like that of an abortion provider, or who operates within 1,000 feet of an abortion provider, or (probably) hasn't spearheaded an all-night vigil for the unborn outside an abortion provider — from receiving funds through the $3 million Abstinence Education Program.

Not that Planned Parenthood participated in AEP; the move was almost purely prophylactic. Much more consequential is HHSC's decision Monday to boot Planned Parenthood affiliates from the state's Medicaid program, which was a direct response to the undercover (and substantially manipulated) videos released in July by anti-abortion activists that included footage from a Houston clinic. The videos prompted investigations from Attorney General Ken Paxton and Governor Greg Abbott, though the termination letter the HHSC's Office of Inspector General sent to Planned Parenthood Gulf Coast on Monday doesn't indicate that investigators did much more than watch the videos:
Earlier this year, you committed and condoned numerous acts of misconduct captured on video that reveal repeated program violations and breach the minimum standards of care required of a Medicaid enrollee. You are being terminated from the program because of these program violations, which include but are not limited to, the following:

I. The videos indicate that you follow a policy of agreeing to procure fetal tissue even if it means altering the timing or method of an abortion. These practices violate accepted medical standards as reflected in federal law, and are Medicaid program violations that justify termination. See 42 U.S.C. 289g-l; Tex. ADMIN.CODE 37 1.1659(2) and (6).

2. You failed to prevent conditions that would allow the spread of infectious diseases among employees, as well as patients and the
general public. Specifically, you allowed individuals posing as commercial buyers of fetal body parts to handle bloody fetal tissue while wearing only gloves. You did not comply with mandatory “universal precautions,” including the use of “protective barriers,”required whenever anyone handles “blood,” “non-intact skin and “body fluids.” See 25 TEX. ADMIN. CODE 139.49; see also 29 CFR 1910.1030. These program violations justify termination. See TEX. ADMIN. CODE 371.1659 (2) and (6)

3. Your staff were not trained in infection control and barrier precautions with regard to the handling of fetal blood and tissue or they failed to comply with the minimum standards that mandatory training requires with regard to these critical public health and safety issues. See 25 TEX. ADMIN. CODE 139.49 (b)(3). These program violations justify termination. See 1 TEX. ADMIN. CODE 371.1659 (2) and (6).
The letter pre-empts criticism of the decision by asserting that excluding Planned Parenthood "will not affect access to care in this State because there are thousands of alternate providers in Texas, including federally qualified health centers, Medicaid-certified rural health clinics, and other health care providers across the state that participate in the Texas Women's Health Program and Medicaid." According to the Texas Tribune, Planned Parenthood received $3.05 million through Medicaid for family planning services.

Abboott was triumphant. “Texas has stepped forward and shown its unyielding commitment to both protecting life and providing women’s health services,” he said in a statement announcing the decision. “The gruesome harvesting of baby body parts by Planned Parenthood will not be allowed in Texas and the barbaric practice must be brought to an end. As such, ending the Medicaid participation of Planned Parenthood affiliates in the state of Texas is another step in providing greater access to safe healthcare for women while protecting our most vulnerable — the unborn.”

Four years ago, the Legislature went a long way toward defunding Planned Parenthood by slashing the state's family planning budget and foregoing tens of millions in federal funds, but cutting a provider out of Medicaid is a much trickier proposition since federal law requires that patients have "free choice of providers." It was for that reason that a federal appeals court tossed out Indiana's attempt to bar Planned Parenthood from the state's Medicaid program. And while Texas officials appear to believe that the videos provide legally defensible grounds for cutting funding to Planned Parenthood, legal experts tend to disagree. Nevertheless, it will be up to Planned Parenthood to fight the cuts in court.