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Judge Says Missouri Legislators Unlawfully Cut Off Planned Parenthood’s Medicaid Funding

David Kovaluk
St. Louis Public Radio

A state court judge in St. Louis on Friday ordered Missouri to restore Medicaid funding to Planned Parenthood’s affiliates in that city.

Judge David L. Dowd ruled that the legislature’s fiscal 2019 appropriations bill for the Medicaid program violated the state constitution by barring payments to abortion providers and their affiliates.

He found the bill ran afoul of the constitution’s requirement that appropriations bills can’t refer to other laws when fixing their amount.

“This isn’t really an abortion issue. This is a how-is-the-legislature-supposed-to-do-business issue,” said Charles Hatfield, Planned Parenthood’s attorney.

A spokesman for Missouri Attorney General Eric Schmitt said the state was considering an appeal.  

An identical case brought by Planned Parenthood is pending in Kansas City. Jackson County Circuit Judge Joel P. Fahnestock, who is hearing the case, said she would decide next month whether to hold off deciding the matter pending any appeal.

The Missouri Department of Health and Human Services suspended Medicaid payments to Planned Parenthood’s St. Louis affiliates a year ago, saying it was required to do so by the appropriations bill.

About 7,000 Medicaid patients rely on Planned Parenthood’s clinics throughout Missouri for a broad array of health services, including birth control, cancer screenings and testing for sexually transmitted infections.

Federal law already bars the use of Medicaid funds for abortions, but the appropriations bill cut off Medicaid funding for all Planned Parenthood's services, not just abortions.

“For decades, Missouri has paid Planned Parenthood for those services,” Hatfield said. “They don't pay for abortions, we all get that. But if a woman goes in there and wants birth control, an IUD, just a normal pelvic exam, the state has reimbursed for that.

“And then the legislature comes along and appropriates money to pay for family planning and physician services and says … but not if you're an abortion provider or anybody who’s affiliated with an abortion provider. And what we alleged, and what Judge Dowd agreed with, is that by doing that in an appropriations bill, they're really amending the statutes, which say ‘Pay for family planning.’”

Both Planned Parenthood of St. Louis Region and Reproductive Health Services of Planned Parenthood of St. Louis Region challenged the Medicaid cutoff. The former does not perform abortions; the latter does.

Dowd’s ruling won’t have an immediate effect, given the state’s likely appeal. And while it’s not binding in the Jackson County case, it could help convince the judge in that case to hand down a similar ruling.

The case is separate from the pending dispute over the St. Louis abortion clinic’s license.

Last week, another judge in St. Louisordered the Department of Health and Senior Services to decide whether to renew the clinic’s annual license by June 21.

The decision keeps open for now the state’s only remaining abortion provider.

Dan Margolies is a senior reporter and editor at KCUR. You can reach him on Twitter @DanMargolies.

Dan Margolies has been a reporter for the Kansas City Business Journal, The Kansas City Star, and KCUR Public Radio. He retired as a reporter in December 2022 after a 37-year journalism career.
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