Missouri Supreme Court: State can't deny Medicaid funds to Planned Parenthood

ANNA SPOERRE, Missouri Independent

Missouri's highest court, for the second time in four years, rebuked lawmakers' efforts to ban abortion providers and their affiliates from receiving Medicaid reimbursements.

The legislature included a line in the 2022 state budget to spend $0 for any Medicaid-covered services if the provider also offers abortions or is affiliated with an abortion provider.

Nearly all abortions are illegal in Missouri. The two Planned Parenthood affiliates operating in the state – Planned Parenthood Great Plains and Planned Parenthood of the St. Louis Region and Southwest Missouri – no longer provide abortions in Missouri, though their counterparts in Kansas and Illinois do.

In a decision Wednesday, the Missouri Supreme Court once again ruled the legislature's attempt to defund Planned Parenthood through the budget was unconstitutional.

The state's Medicaid program, which serves low-income and disabled Missourians, has long banned funding for abortion, with limited exceptions. Medicaid has reimbursed Planned Parenthood in the past for reproductive health services that do not include abortion, including STI and cancer screenings, as well as contraceptives.

Planned Parenthood has said it hasn't received any state funds for nearly two years as this legal fight played out in court, though the organization's clinics continued to treat all patients, regardless of insurance.

Advocates for Planned Parenthood have said cutting off Medicaid funding would only hurt those most in need of care. Anti-abortion Republican lawmakers have said they don't want any state funds going to organizations affiliated with abortion providers.

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.

After the state legislature voted to block Planned Parenthood from receiving Medicaid reimbursements in 2022, the organization sued. In December, Cole County Circuit Judge Jon Beetem concluded the state couldn't deny access to funds available to other healthcare providers.

In his 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."

A hearing before the state Supreme Court last November centered on whether Planned Parenthood should have first taken the matter to the Administrative Hearing Commission, as well as whether Planned Parenthood had contractually waived any claim to funding or had the legal ability to sue.

The state argued that Planned Parenthood "ran straight to court" when they should have gone to the Administrative Hearing Commission, while Planned Parenthood called those arguments "meritless procedural roadblocks." The courts were the correct venue because the questions at hand were constitutional, the organization argued.

The Supreme Court, in its ruling, said even if the court were to find that the state did not violate the constitution, "this Court must affirm the circuit court's judgment because the State does not contend the circuit court erred in entering judgment on Planned Parenthood's equal protection claim."

While the latest case was still pending, Missouri lawmakers proposed new legislation that would change Missouri law to make Planned Parenthood ineligible to receive reimbursements from MO HealthNet, the state's Medicaid program.

Planned Parenthood's attorney in the most recent case, Chuck Hatfield, argued in November that changing state law was the only constitutional way for the legislature to exclude a provider from the Medicaid program.

Vanessa Wellbery, vice president of policy and advocacy for Planned Parenthood of the St. Louis Region and Southwest Missouri, said at a state Senate hearing last month that nearly 20% of the patients of Planned Parenthood affiliates in Missouri rely on Medicaid.

The Missouri Attorney General's Office did not immediately respond to a request for comment.

Yamelsie Rodriguez, president and CEO of Planned Parenthood of the St. Louis Region and Southwest Missouri, and Emily Wales, president and CEO of Planned Parenthood Great Plains, in a joint statement, called the ongoing efforts to defund Planned Parenthood "cruel and irresponsible."

"Today, the Missouri Supreme Court again reaffirmed our patients' right to access critical care like cancer screenings, birth control, annual exams, STI testing and treatment, and more at Planned Parenthood health centers," they wrote Wednesday. "Over and over again, the courts have rejected politicians' ongoing attempts to deprive patients of their health care by unconstitutionally kicking Planned Parenthood out of the Medicaid program."

They added that "the fight for patient access is far from over."

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Anna Spoerre covers reproductive health care for The Missouri Independent. A graduate of Southern Illinois University, she most recently worked at the Kansas City Star, where she focused on storytelling that put people at the center of wider issues. Before that, she was a court reporter for the Des Moines Register.