LegeLand: Defunding Planned Parenthood

Texas Attorney General Greg Abbott (Photo by Jana Birchum)

A pair of rulings from Texas Attorney General Greg Abbott seems to set the stage for Texas lawmakers to exclude Planned Parenthood from participation in the successful Women's Health Program, which in 2008 alone saved the state more than $40 million in health-related costs.

To recap: Sen. Robert Deuell, R-Greenville, last summer requested an opinion from Abbott as to whether a provision of the state's Human Resources Code would pass constitutional muster if interpreted to ban Planned Parenthood from receiving federal funds for WHP. Deuell for several sessions now has been focused on defunding PP because certain clinics do perform abortions (though public funding supports pregnancy terminations only in very rare circumstances). Deuell would rather have the funds go first to support federally qualified health centers. An FQHC offers a one-stop health shop, whereas Planned Parenthood is more narrowly focused, Deuell has argued. Unable to serve as many clients as Deuell would like, however, the health centers have consistently had to return funds to the state ($1.2 million last year) for reallocation to other providers, including PP, which in 2009 served 40% of all WHP clients.

Deuell's letter to Abbott essentially asked whether the state could exclude Planned Parenthood from the funding because of a statutory provision that the state won't contract with "affiliates of entities" that "perform or promote" abortion. A similar question had previously been litigated as it applied to the distribution of Title X funding, the main federal source of family-planning funds. In that case, the short answer was: No, you can't exclude PP just because you dislike one portion of its business, a portion that is legally protected. Still, the litigation prompted the state's 71 Planned Parenthood affiliates to separate themselves from one another, creating different branding, boards of directors, and signage, so that health clinics wouldn't be associated with the clinics that provide abortion services.

According to Abbott's opinion, however, that deaffiliation doesn't impact the state's ability to deny Planned Parenthood funding for WHP, which comes from Title XIX funds and which cover Medicaid costs. In other words, the opinion concludes that the rules for Title X and Title XIX are not the same.

Meanwhile, in a second opinion, Abbott ruled that the commissioner of the Health and Human Services Commission, which administers the WHP program, may adopt "a specific definition of the term 'affiliate'" to further narrow the list of organizations eligible to receive WHP money – so long as the new definition "does not impose additional burdens, conditions, or restrictions." At this point, it seems the only thing left in common between the Planned Parenthood clinics that provide abortion care and those that provide family-planning and preventative women's health exams is simply the name "Planned Parenthood." Will the state seek to define an affiliate as an entity that shares only an umbrella name? If so, that could backfire: What about hospital systems, such as Dallas' Parkland Hospital, where abortion services are provided under the umbrella entity? In other words, you can smell a new lawsuit coming.

The assault on PP isn't confined to Texas. Last week, federal lawmakers voted to eliminate PP from receiving any federal funds for family planning and preventative health care. Even more potentially damaging, lawmakers are also considering eliminating Title X family-planning funding altogether, which could leave more than 5 million low-income women without access to basic health care.