Almost six months ago, undercover videos surfaced purporting to show officials with Planned Parenthood in Texas discussing illegal acts. Texas Republicans pounced, opening up multiple battlefronts against the embattled women’s health organization.
With allegations flying that Planned Parenthood was illegally selling fetal tissue, state leaders quickly pressed for state and local investigations. They used the recordings — including video of Planned Parenthood staff in Houston discussing the use of fetal tissue in medical research — to propel their calls for cutting off all state and federal money to the organization.
The sale of fetal tissue is illegal. But if a patient consents, abortion clinics may donate fetal tissue for use in medical research. Federal law allows clinics to be reimbursed for costs “associated with the transportation, implantation, processing preservation, quality control, or storage of human fetal tissue” for research purposes.
Planned Parenthood health centers in Texas do not currently donate tissue for medical research, their officials say, and Planned Parenthood Gulf Coast in Houston hasn't done so since 2010, when it partnered with the University of Texas Medical Branch at Galveston for a study on causes of miscarriages.
Months after the flare-up, Republican efforts to investigate or curtail the organization have produced few results. Here's the scorecard so far:
Harris County's investigation
This week, a Harris County grand jury empaneled to investigate whether Planned Parenthood was illegally selling fetal tissue cleared the group of wrongdoing, instead indicting two anti-abortion activists behind the undercover recordings.
The indictments — for tampering with a governmental record and unlawfully offering to buy fetal tissue — surprised Republicans and Democrats. The investigation was initiated by Harris County District Attorney Devon Anderson, a Republican, at the urging of Republican Lt. Gov. Dan Patrick.
“We were called upon to investigate allegations of criminal conduct by Planned Parenthood Gulf Coast,” Anderson said in a statement. “As I stated at the outset of this investigation, we must go where the evidence leads us."
Republican state leaders largely brushed off the indictments while some activists accused the grand jury of going rogue.
Planned Parenthood has hailed the grand jury's actions as vindication of its vehement denials that its staff violated any laws. Organization supporters say the felony charges against the videographers throw a wrench into the state's current campaign, which is largely based on the videos.
“I haven’t seen any indication that the governor or lieutenant governor of Texas cares what happens to women at all," Cecile Richards, president of Planned Parenthood Federation of America, said in an interview with The Texas Tribune. "It seems to me their entire campaign against women here has been based upon their political beliefs and not about the well being of the people of Texas."
Planned Parenthood’s Medicaid contract
Perhaps the biggest fallout from release of the undercover videos was the state’s move to boot Planned Parenthood from the state Medicaid program, through which it receives $3.1 million a year to help low-income women access family planning and well-woman services.
But three months after the state announced its intent, Planned Parenthood is still treating patients through the program, which is separate from the organization's abortion services.
In an effort to cut off the stream of taxpayer Medicaid funding — the vast majority coming from the federal government — the state Health and Human Services Commission in October sent Planned Parenthood a “notice of termination” announcing it was axing the organization’s Medicaid contract. In the notice, state health officials cited the videos and unspecified allegations of Medicaid fraud, saying it would soon issue a final notice to officially nix the funding.
The notice prompted Planned Parenthood to file a federal lawsuit to block Texas’ efforts.
But despite claiming it had proof of misconduct disqualifying Planned Parenthood as a Medicaid provider, state health officials have yet to deliver the final legal notice to defund the organization.
With no final notice, Planned Parenthood’s lawsuit is stalled in court. A December hearing was cancelled, and this week, the state and Planned Parenthood agreed to put the case on hold until Texas formally ends the organization’s contract, according to court documents.
A spokesman for the health commission’s inspector general declined to comment on the delayed final notice and imminent legal battle, citing the pending litigation.
"While we don't know why the state has delayed, we do know that the state's actions have been politically motivated from the start,” said Alice Clapman, an attorney for Planned Parenthood Federation of America. “As the accusations against Planned Parenthood continue to fall apart, we hope the state will change course."
Despite the surprising indictments out of Harris County, Republican leaders insist the state is moving forward with its own investigations of Planned Parenthood’s practices — one by Attorney General Ken Paxton, another by the health commission — also spawned by the release of the undercover videos.
“Nothing about today’s announcement in Harris County impacts the state’s ongoing investigation," Gov. Greg Abbott said in statement
State officials have been tight-lipped on the details of the inquiries, but they have included visits by state investigators to Planned Parenthood facilities, subpoenas for documents to three Planned Parenthood affiliates and a review of “hours of recordings” of Planned Parenthood.
Other states have already cleared Planned Parenthood of wrongdoing in light of the videos, but there’s no indication when the Texas inquiries will be completed, and whether the state has grounds to press charges against Planned Parenthood.
HIV prevention and abstinence education funding
Since the videos were released, the state has quietly worked to cut off other, smaller taxpayer funding streams that Planned Parenthood could tap.
In August, health commission officials adopted guidelines to prohibit entities even loosely affiliated with abortion providers, namely Planned Parenthood, from applying for contracts under the state’s Abstinence Education Services program.
And in December, Texas health officials informed Planned Parenthood Gulf Coast that it would not renew its long-standing contract with the provider for HIV prevention services, cutting off almost $600,000 in annual funding.
The prevention dollars, which the health care provider used for HIV testing and counseling, condom distribution and referral consultants, are federal funds managed by the state. Texas health officials did not provide a reason for refusing to renew the contract, but Planned Parenthood insisted the cut was an “attempt to score political points.”
Citing the grand jury’s indictments of the anti-abortion activists, the gay rights group Equality Texas has called on health officials to reinstate Planned Parenthood’s contract.
“Equality Texas understands firsthand how the spread of malicious lies and false accusations of illegal activity can affect the public safety and public health of LGBT communities,” said Equality Texas executive director Chuck Smith.
Fetal tissue legislation
What is certain is that lawmakers returning to the Capitol in January will push for legislation to restrict fetal tissue donations in the state.
Following the release of the Houston video, Abbott in August endorsed a flurry of related restrictions. But while the governor echoed similar proposals by Republican senators discussed during a July hearing, he stopped short of calling lawmakers to Austin for a special session on his proposed legislation.
Instead, the Senate Health and Human Services Committee, which has taken up the issue, is expected to lay out the legislation it’ll move forward with in its interim report due this fall.
At a minimum, Republicans look poised to increase state regulators’ power over the issue, but they could go as far as banning fetal tissue donations in Texas altogether — something that could undercut research institutions that are not affiliated with Planned Parenthood.
"As the state is still conducting an ongoing investigation into Planned Parenthood's activities in Texas, I don't see this week's announcement out of Harris County fundamentally changing the situation,” said committee chair Republican state Sen. Charles Schwertner of Georgetown. “In the upcoming session, I still fully expect to work with my colleagues in the Texas Legislature to pass new legislation banning the sale of fetal tissue and affirming the sanctity of human life."
Disclosure: Planned Parenthood was a corporate sponsor of The Texas Tribune in 2011. A complete list of Tribune donors and sponsors can be viewed here.