AUSTIN (CN) — A federal judge Thursday stopped Texas from zeroing out $4 million in annual Medicaid funding for Planned Parenthood — a termination that Texas hoped to inflict on Saturday.
U.S. District Judge Sam Sparks said he will issue a ruling within a month, after he reviews hundreds of exhibits and hours of videos, and he granted Planned Parenthood a temporary injunction blocking the Medicaid termination until Feb. 21.
The Texas Health and Human Services Commission sent Planned Parenthood a final notice on Dec. 20 last year, terminating its Medicaid funding.
In a hearing that began Tuesday, Planned Parenthood attorneys said the funding cut would have a “devastating” effect on nearly 11,000 Medicaid patients who rely on their clinics for family planning and basic health services.
Planned Parenthood attorney Jennifer Sandman on Thursday asked Judge Sparks to “enjoin the state of Texas from continuing to attack women.”
“If these people don’t get to choose Planned Parenthood … that is irreparable harm,” she said.
Texas Health and Human Services Inspector General Stuart Bowen, who testified Wednesday, said the termination was based on undercover video taken by members of an anti-abortion group called the Center for Medical Progress. Bowen said the footage depicts clinic employees discussing their “willingness” to modify an abortion procedure to procure fetal tissue for research, which would violate ethical and medical standards.
“This is the closest that anyone has ever been to seeing what takes place inside a Planned Parenthood,” Assistant Attorney General Andrew Stephens said during his closing argument for the state.
Planned Parenthood attorneys said the video shows employees discussing potential alterations to their standard methods of handling fetal tissue after an abortion, not alterations to the surgical procedure.
After the Center for Medical Progress released heavily edited versions of the video, surreptitiously recorded at the Planned Parenthood Gulf Coast clinic, several states, and congressional Republicans, cited the video in attempting to disqualify Planned Parenthood from federal funding.
Texas officials, including Bowen, testified that they had no evidence that any doctor working for Planned Parenthood in Texas has ever altered an abortion procedure to benefit research.
Attorney Sandman said during the Thursday hearing that even if the video shows a sufficient basis to oust Planned Parenthood Gulf Coast from Medicaid, it “cannot be sufficient” to extend that termination to clinics run by Planned Parenthood South Texas and Planned Parenthood of Greater Texas.
There are 34 Planned Parenthood clinics in Texas, eight of which are run by the Gulf Coast organization.
“The idea that all of these centers could be terminated based on the alleged misconduct of one speaks for itself,” Sandman said.
Texas terminated funding to all Planned Parenthood clinics in the state, claiming they are affiliated, but Sandman said there is no ownership or control relationship between the three organizations, and the state’s only basis of affiliation is that the health care groups share the same name.
Sparks summarized the state’s reasoning: “Their contention is that it’s contagious, and when one gets a disease, all of them have to go to the hospital,” the judge said.
Texas Associate Commissioner for Medicaid Services Jami Snyder testified that Medicaid patients who receive care from Planned Parenthood can get the same services and level of care at one of the 141,000 other health care providers in the Texas Medicaid program.
She conceded, however, that not all those providers offer the same services as Planned Parenthood, or are accepting new patients, and she could not confirm that every county in Texas has a sufficient number of family planning providers.
Planned Parenthood’s rebuttal witness Amanda Stevenson, a reproductive health researcher, said that killing Medicaid funding to Planned Parenthood would increase the number of unplanned pregnancies and abortions in Texas.
She cited a New England Journal of Medicine article she co-authored in 2016, which tracked the effect of the Planned Parenthood’s exclusion from a state-funded Medicaid replacement program. The study showed a 27 percent increase in births paid for by Medicaid in areas in Texas where Planned Parenthood was no longer a health care provider.
During closing arguments, Sandman read testimony from several Jane Does, Planned Parenthood Medicaid patients who are co-plaintiffs with the three Texas Planned Parenthood organizations. They described why they chose to go to Planned Parenthood.
One said it had been difficult for her to trust medical professionals after a bad experience with an emergency room doctor who examined her after she was raped. She said that doctor was neither “empathetic” nor “helpful,” but doctors and staff at a Planned Parenthood clinic she later visited “worked hard to put her at ease.”
“It is an open and accepting environment,” she said. “I am not comfortable with other doctors.”
Sandman said that many patients prefer visiting Planned Parenthood because of the “non-judgmental, compassionate” care they receive. Unlike many other health care providers in the Medicaid program, Sandman said, Planned Parenthood offers evening and weekend hours, offers same-day appointments, and is always accepting new patients.
She pointed out that state standards ensure only that Medicaid patients have access to an OB-GYN doctor who practices within 75 miles of the patient’s residence.
“Seventy-five miles is what the state is saying is acceptable,” Sandman said. “That ignores the reality of women’s lives, especially the lives of people living at 20 percent of the national poverty level.”