For the second time in three years, the issue is in the hands of the state’s highest court.
This was the second time in three years that the state’s high court has heard arguments.
Planned Parenthood sued after the Missouri state legislature voted to block the organization from receiving Medicaid reimbursements in 2022. In December, Cole County Circuit Judge Jon Beetem ruled that the state couldn’t deny access to funds available to similar health care providers.
The attorney general’s office appealed the ruling on behalf of the Department of Social Services, the state agency which oversees Missouri’s Medicaid program. It argued that the “entire purpose of the appropriations process is to prioritize funds.”
In a statement, Missouri solicitor general Joshua Divine said, “I can’t stress this enough; A ruling for Planned Parenthood on the constitutional issue would create catastrophic aftershocks that would wreck the appropriation process that has been used for decades.”
Planned Parenthood argues that the appropriations bill conflicts with certain statutes; therefore, the state would only be constitutionally permitted to zero out the funding if they change the statute.
“The $0 appropriation is an appropriation bill that changes the substantive law to deny an eligible provider with a contract access to Medicaid funding,” stated Chuck Hatfield, an attorney representing Planned Parenthood, “and that you cannot do.”
In 2020, the Supreme Court struck down language in a similar budget bill that excluded abortion providers or their affiliates from receiving Medicaid reimbursements, citing it as a “naked attempt” to legislate through a budget bill.
“Here we go again,” Hatfield mused, “with a long line of cases where this court has met its responsibility…to advise the legislature on the limits of its authority when it comes to appropriation.”
Debate Over Proper Procedure to Restrict Funds
2022’s appropriations bill included a line item to spend $0 for Medicaid-covered services — but only if the provider offers abortions, or is affiliated with an abortion provider. Reimbursements to Planned Parenthood for reproductive health services covered STI screenings, cancer screenings and contraceptives.
Missouri’s Medicaid program has historically banned funding for abortion (with limited exceptions), and since last year’s U.S. Supreme Court decision overturning the constitutional right to an abortion, it has been banned in the state.
Planned Parenthood and its defenders characterize legislative attempts to restrict the organization’s funding as, “a broader attack on access to reproductive health care”. Anti-abortion advocates contend the state should not be allowed to use taxpayer dollars to subsidize abortion providers.
In his December ruling, Cole County Circuit Judge Jon 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.”
Wednesday’s hearing 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 Planned Parenthood “ran straight to court” when they should have gone to the administrative hearing commission, while Planned Parenthood characterized those arguments as “meritless procedural roadblocks.”
Planned Parenthood argued that the courts were the correct venue because the questions at hand were constitutional.
Missouri solicitor general Joshua Divine said this case differed from the 2020 case because lawmakers made a “literal front-end appropriation,” which provided zero dollars for Planned Parenthood. “There has never been any dispute that the legislature can constitutionally restrict Medicaid funds from Planned Parenthood if it wants to do so,” Divine said. “It just has to go through the proper procedures.”
Divine went on to say that the legislature “tacked on this additional language at the end,”in 2020 — after already appropriating the funds. In this case however, the two categories of funding for organizations receiving Medicaid funds “simply exclude Planned Parenthood, just like they exclude many other organizations.” When asked by a judge whether any other providers were excluded, Divine said “I don’t think the record makes that clear.”
“…Here the legislature said what we’re excluding from the $60 million pot is abortion providers and their affiliates,” Divine explained, “so the Planned Parenthood providers are clearly in that but I think other affiliates, some other organizations that might not be before this court would also be excluded.”
The issue itself has been around for decades: Missouri lawmakers have been attempting to restrict public funds from going to Planned Parenthood since the mid-90s.