Missouri’s Planned Parenthood branches have been cut off from Medicaid funding. And while the organization is challenging the law, it’s also figuring out how to continue care for low-income patients in case it’s permanently removed from Medicaid.
This is the third time Missouri lawmakers have tried to remove Planned Parenthood from the Medicaid program. In 2022, the GOP-controlled legislature passed a budget law that was later struck down by a county judge.
Earlier this year, Gov. Mike Parson signed into law a bill that forbids Missouri’s Medicaid program from reimbursing Planned Parenthood for health care services. The law went into effect in late August. Planned Parenthood filed a legal challenge in response.
Since 2022, Planned Parenthood says it’s been relying on a combination of grants and donations to absorb the cost of Medicaid recipients that use its services.
Nick Dunne is the communications director for Planned Parenthood Great Rivers, which covers St. Louis and southern portions of the state. He said the organization will continue to see Medicaid patients as the state law is challenged.
“Our patients come first,” Dunne said. “So we’re going to continue to absorb these costs as if they are still using their Medicaid while this plays out in court.”
Planned Parenthood reports nearly one in five of its patients is insured by Medicaid. The insurance can cover contraceptive access, sexually transmitted infections treatment, cancer screenings and more.
Dunne said donations have helped cover the cost for these patients for now. However, the organization is looking for longer-term solutions.
Emily Wales is the CEO of Planned Parenthood Great Plains, which covers the rest of Missouri. She said private donations are helpful, but the biggest pot of money supporting Planned Parenthood is a federal fund called the Title X Family Planning Program.
Established in 1970, Title X is the only dedicated federal fund for reproductive health care. It covers services that include breast and cervical cancer screenings, HIV prevention and treatment, and pregnancy care.
“Title X funding is a very different type of grant where we estimate the number of patients we’ll support,” Wales said. “We get an allocation of federal funds for a certain amount of care. If we get $10,000 and we end up needing maybe $12,000 or $14,000 … we talk to donors to offset the cost of those services.”
But Wales said there’s a problem. If Planned Parenthood loses its legal challenge, it may have to rely more on Title X than it already does.
“That just takes a really strained safety net and makes it even more difficult for us to find resources to pay for patients,” Wales said.
The group in charge of dispersing Title X funding is the Missouri Family Health Council. Every year, the council receives around $5 Million to distribute to 55 health clinics across the state.
The council works with a network of clinics and medical providers across the state to provide funding for different reproductive health initiatives.
“We really look at reducing all costs and other barriers that people may face when accessing services — how to make sure those that may be uninsured or underinsured still have (health care) access,” said Michelle Trupiano, the council’s executive director.
However, Trupiano said if Planned Parenthood is kicked off Medicaid and has to tap into Title X more, it will make it harder to distribute these limited resources equitably.
She said she’s also worried more patients will go to medical centers for treatment, which potentially strains hospitals.
“Other providers within the safety net simply cannot absorb thousands of patients,” Trupiano said.
Local health departments are foreseeing some of these concerns as well. For a smaller health department like the one in Dent County, this funding can be critical.
The Dent County Health Center serves more than 14,000 people throughout south-central Missouri. And when it comes to uninsured or low-income patients, Title X can be a lifeline.
“Title X does pay quite a bit for our patients,” Dent County Health Center Administrator Zachary Moser said. “Anybody who makes less than 100% of the federal poverty level doesn’t have to pay anything. So that’s all being supported by the Title X program.”
Moser also said Title X can help fund supplies, nursing costs and make contraceptive procedures free.
In southeast Missouri, the Butler County health department staff say it also relies on Title X funding to cover pap smear testing. Nurse Kami Wilson said she worried about what could happen if Title X funding was harder to access.
“It definitely will affect our ability to provide the free and lowest cost birth control that’s provided to the community here,” Wilson said.
For now, Planned Parenthood says it will continue to absorb the cost of Medicaid patients while it hopes to win its case.
Planned Parenthood filed its lawsuit at the end of August. There has been no indication of when the case might be heard.
This story was originally published by the Missouri Business Alert, a fellow member of the KC Media Collective.
