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Judge's Reversal Gives State Go-Ahead to Exclude Planned Parenthood Clinics

A federal judge's ruling this morning means that the state may begin removing Planned Parenthood and other so-called abortion "affiliates" from the Women's Health Program, despite a district judge's Monday ruling to the contrary.

La'Tonya Ephraim speaks with Carrie Adney, a Women's Health Program client since last year, at Seton-Circle of Care Women's Services in Round Rock, TX.

Updated, 9:30 a.m.:

A federal judge's ruling this morning means that the state may begin removing Planned Parenthood and other so-called abortion "affiliates" from the Women's Health Program, despite a district judge's Monday ruling to the contrary.

Health and Human Services Commission spokeswoman Stephanie Goodman said Tuesday morning that the state has been granted an emergency motion for stay after Attorney General Greg Abbott filed an appeal  last night in the Fifth Circuit Court of Appeals. Goodman says this means the preliminary injunction granted to Planned Parenthood on Monday in district court will not take effect, and the state will "fully enforce state law today and exclude abortion providers from the Women's Health Program." The court is requesting a response from the Planned Parenthood affiliates by 5 p.m.

In a statement to the Tribune, Melaney Linton, president and CEO of Planned Parenthood Gulf Coast, said the clinics in the lawsuit — none of which provide abortions — are"disappointed" by the action.

"We are optimistic that when the state's motion for a stay is fully considered, the district court's order that Texas cannot prevent Planned Parenthood from providing cancer screenings, birth control, screenings for high blood pressure and diabetes, and STD testing as part of the Women’s Health Program will stand," Linton said. "When presented with both sides, the district court agreed the rule was likely unconstitutional, and that implementation would cause a serious problem with health care access for Texas women."

On Tuesday evening, attorneys for the Planned Parenthood affiliates submitted a brief to the court requesting that Judge Jerry Smith repeal the stay and maintain the current system in which clinics are reimbursed only for services permitted under the WHP. They argued there is nothing in state law that mandates Texas has to shut down the program if the preliminary injunction remains. Lawyer Helene Krasnoff also challenged the state's claims that Planned Parenthood delayed the filing of their lawsuit.

"(T)he stay cannot be in the public interest because as the district court ruled, it would harm tens of thousands of low-income women who rely on Plaintiffs for basic, preventive health care," Krasnoff wrote. "If this court stay is lifted and the district court's preliminary injunction is in effect, HHSC will not sustain any 'costs or damages' at all should the injunction later be held improper."

Judge Smith is expected to respond within the next 48 hours. 

State officials say any women who need help finding a new WHP provider can call 1-800-335-8957.

Updated, 4:20 p.m.:

Gov. Rick Perry's spokeswoman, Catherine Frazier, just issued the following statement following today's ruling:

“Texas has a long history of protecting life, and we are confident in Attorney General Abbott’s appeal to defend the will of Texans and our state law, which prohibits taxpayer funds from supporting abortion providers and affiliates in the Women’s Health Program. We will continue to work with the Attorney General to pursue all available legal options."

Original story:

A district judge in Austin has ordered Texas to temporarily stop its enforcement of a rule that would have removed 49 Planned Parenthood clinics from the state’s Medicaid Women’s Health Program starting May 1.

In a 25-page opinion, U.S. District Judge Lee Yeakel ruled that the Planned Parenthood organizations that filed the lawsuit proved there could be irreparable harm to their clinics that rely on Women’s Health Program funding to help uninsured Texans access cervical and breast cancer screenings, birth control and STD testing. Yeakel also expressed doubt that the state could find enough providers by Tuesday to replace the Planned Parenthood clinics with other health providers.

“The record demonstrates that plaintiffs currently provide a critical component of Texas' family-planning services to low-income women," Yeakel wrote. "The court is unconvinced that Texas will be able to find substitute providers for these women in the immediate future, despite its stated intention to do so." 

In a statement today, Stephanie Goodman, a spokeswoman for Texas' Health and Human Services Commission, said the agency has received the order and will comply with the ruling, "but we remain confident that federal law gives states the right to establish criteria for Medicaid providers. We will work with the Attorney General’s Office to determine our next steps."

It's unclear how far-reaching the ruling is. Texas officials have stated their intention to run the program without federal help — and without Medicaid dollars. This could largely make Yeakel's opinion moot. 

The clinics alleged that the Health and Human Services Commission’s rules infringed on their constitutional rights to free speech and to associate with the Planned Parenthood Federation of America, an organization that supports access to “safe and legal” abortion services. In Texas, none of the 49 clinics that received WHP funding performed abortions, but they referred women seeking the procedure to clinics that do.

Yeakel ruled that the commission’s rules requiring all Women’s Health Program providers to certify that they “do not promote ‘elective abortions’ and that they do not ‘affiliate’ with entities that perform or promote elective abortions” indicates that “Texas is reaching beyond the scope of the government program and penalizing plaintiffs for their protected conduct.”

Though Yeakel ruled in Planned Parenthood’s favor, he made clear this is a preliminary ruling that preserves the “status quo … until a thorough airing of the issues by trial occurs. The court observes that if the federal funds are phased out, Texas does not provide another source of funds, and the Women's Health Program terminates, the controversy now before the court may be of no consequence.”

The court rejected the state’s argument that providing Planned Parenthood with government funds “for non abortion-related activities effectively ‘frees up’ organizational funds for use on abortion-related services." Yeakel also wrote that Health and Human Services Executive Commissioner Tom Suehs did not sufficiently prove that funding had been mismanaged or that the state can “condition participation” in the program. 

In their initial request for the injunction, the Planned Parenthood clinics argued they stood to lose about $13.5 million in annual funding for preventive health and family planning services. The loss of funding on May 1 would have probably led to clinic closures statewide and the immediate layoffs of employees — directly affecting about half the clients in the Women’s Health Program, most of whom are uninsured and have gone to Planned Parenthood for cancer screenings, birth control and STD testing.

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Health care Abortion Health And Human Services Commission Medicaid Women's Health Program