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Planned Parenthood, Missouri battle over Medicaid funding before Supreme Court


JEFFERSON CITY, Mo. — The Missouri Supreme Court heard oral arguments this week regarding the General Assembly’s decision to withhold Medicaid funds from “any abortion facility … or any affiliate or associate” in an appropriations bill for the 2019 fiscal year. 

The case stems from the 2018 Republican-led legislature’s decision to withhold Medicaid funding from abortion providers in its appropriations package — a decision that could impact a dozen Planned Parenthood facilities across Missouri. Only one clinic, however, is able to provide abortion services. 

Planned Parenthood has challenged the ruling, alleging lawmakers violated state law which requires MO HealthNet funding to include family planning services. By withholding Medicaid funding, Planned Parenthood attorneys argued Tuesday lawmakers are changing state statute through the appropriation package. 

But Solicitor General John Sauer said that statute does not “provide an entitlement to be reimbursed to any specific provider.” He argued before the Supreme Court that Planned Parenthood’s arguments are “not rooted in the plain text of the constitution.” 

“I think the better interpretation of [state statute] is while they provide an entitlement to eligible, needy individuals, they do not create this sort of free-standing entitlement to any particular provider or class of providers,” Sauer said. 

Judges Patricia Breckenridge and Laura Denvir Stith handled most of the questions during Tuesday’s oral arguments. 

Since the appropriations bill, Planned Parenthood facilities in the St. Louis region have only seen an 11 percent decline in the number of Medicaid patients seen. And this year, the clinics are on track to serve an increased number of patients, spokesman Jesse Lawder said. 

“This shows people really want care at Planned Parenthood, and there are not enough skilled providers,” Lawder told The Missouri Times. 

Figures for the Planned Parenthood Great Plains region were not immediately available.

So how did we get here?

Following Tuesday’s arguments, Planned Parenthood attorney Chuck Hatfield told reporters he wanted the Missouri Supreme Court to hear oral arguments this year in order to potentially stop the legislature from continuing to withhold funding in yet another appropriations bill. 

After the passage of the appropriations package, the Planned Parenthood of the St. Louis Region and Reproductive Health Services of Planned Parenthood of St. Louis Region appealed to the Administrative Hearing Commission (AHC), the state’s tribunal. 

The AHC sided with the state but did not take up Planned Parenthood’s constitutional arguments because it lacked jurisdiction. The case then went to the Circuit Court for the City of St. Louis, which sided with Planned Parenthood. 

The seven-member Supreme Court did not issue a ruling on Tuesday. 

The battle over Medicaid funding comes as the state is involved in multiple legal disputes with Planned Parenthood, including over the abortion clinic’s license. Additionally, a law banning abortions after eight weeks, signed by Republican Gov. Mike Parson earlier this year, is stymied in court