Medicaid can be cut from Planned Parenthood in Texas, Louisiana, 5th Circuit rules

Dissent argued the decisions would leave millions 'vulnerable to unlawful state interference with their choice of health care providers'

A federal appeals court ruled Monday that Texas and Louisiana can cut off Medicaid funding to Planned Parenthood clinics, reversing an earlier appellate ruling that blocked Texas from enforcing its ban. 

The 5th U.S. Circuit Court of Appeals' decision expressly reversed decisions in Texas and Louisiana, but the ruling also affects Mississippi, which is under 5th Circuit jurisdiction. 

The decision by the full 5th U.S. Circuit Court of Appeals in New Orleans reverses an earlier ruling by a three-judge appellate panel that blocked Texas from enforcing its ban on Medicaid funding of Planned Parenthood. It also expressly reversed a ruling in a separate case blocking Louisiana from banning Planned Parenthood funding. A three-judge panel in 2015 had ruled against the ban, and that decision stood when the full court deadlocked 7-7 in 2017 when there were only 14 active judges on the court.

The court's personnel has changed since then. Six nominees of Republican President Trump now sit on the court. Four of them participated in Monday's case (one was recused and another joined the court too late to take part) and all four joined Judge Priscilla Owen's opinion for an 11-member majority.

Owen entered the opinion, which concluded that Planned Parenthood affiliates weren't able to contest the state's determination that it is not qualified to receive Medicaid funds.

In dissent, Judge James Dennis wrote that the ruling conflicts with other circuits’ decisions and will leave millions of people in Texas, Louisiana and Mississippi “vulnerable to unlawful state interference with their choice of health care providers.”

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Planned Parenthood CEO Alexis McGill-Johnson argued the Texas Medicaid ban "would have a devastating impact on Texans."

"@GovAbbott knows exactly who he’s hurting — people of color, women, and people with low incomes," she tweeted.

Abby Johnson, former director of a Texas Planned Parenthood affiliate, told Fox News: "There’s no reason for women to go to Planned Parenthood to receive health care when they can go to far superior health care centers and receive more comprehensive health care services."

"Planned Parenthood provides EXTREMELY [sic] limited services and has to refer out for almost all services that women and men may need throughout their lifetime," Johnson said. She added that it made more sense to send the funds to Federally Qualified Health Centers.

According to the Planned Parenthood Action Fund website, "About a third of the revenue received at Planned Parenthood (34%) is from government health services reimbursements and grants, such as Medicaid and Title X. In 2017, those reimbursements and grants added up to $564 million — all of which went to health centers for medical services." 

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Monday's ruling underscored the ongoing impact of journalist David Daleiden's explosive undercover videos from 2015. While media outlets and Planned Parenthood have described the footage as misleading and highly edited, an appeals court contradicted that narrative in 2019, arguing the videos were "not deceptively edited." 

Daleiden told Fox News: "The full federal 5th Circuit's decision this week confirms that our undercover footage is accurate and reliable evidence of serious criminality in the abortion industry and fetal trafficking enterprises, and it affirms the broad authority that state and federal administrators have to defund entities like Planned Parenthood for illegally selling the body parts of aborted infants."

The dissent and majority clashed over the validity of Daleiden's videos in the case. Dennis noted that after reviewing Daleiden's videos, he agreed with a district court's opinion that Texas had no "factual support to conclude the bases of termination."

The Texas Health and Human Services Commission cited Daleiden's footage in its final notice to Planned Parenthood affiliates that it was terminating their Medicaid enrollment. In the notice, the commission's inspector general justifies his decision by pointing to the Texas affiliates' connection to the national organization -- indicating that it believed its decision would be legitimate independent of any specific wrongdoing found at state affiliates.  

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In severing Medicaid funding, former Louisiana Gov. Bobby Jindal also referenced Daleiden's claims that Planned Parenthood altered its procedures to obtain intact fetal tissue. That allegation appeared to be corroborated by testimony released earlier this year in which two of the doctors featured in the videos confirmed they altered abortions while obtaining fetal tissue. Although both maintained the "procedure" itself never changed, critics dismissed this phrasing as a bogus attempt to skirt federal law surrounding fetal tissue trafficking.

Unsealed documents also revealed Planned Parenthood charged a biospecimen company nearly $25,000 for fetal tissue and maternal blood samples in 2012. Planned Parenthood has defended itself by claiming that the charges are related to transportation and time spent by staff. The invoices don't mention either of those, however, nor do they contain the word "reimbursement." Instead, they assign a fee per body part. Specifically, the previously released contract between those organizations showed that the exchanges were based on "POC determined in the clinic to be usable."

The abortion provider has vehemently denied selling fetal tissue and points out that multiple state-level investigations failed to find evidence of sales or profiting off tissue. It also successfully sued Daleiden for millions of dollars, although that trial provided testimony that renewed congressional scrutiny of the organization this year. 

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The Justice Department has yet to announce the results of a pending investigation it opened into Planned Parenthood after receiving criminal referrals from Senate Republicans. Some of those referrals, and much of Daleiden's work, pertained to entities in California, which, unlike some other states, declined to investigate under then-Attorney General Kamala Harris.

Along with other state-level bans, the legislation could reach the U.S. Supreme Court, which previously rejected Louisiana's controversial regulations on abortion clinics. 

The Associated Press contributed to this report.