State: Ax Medicaid-suit injunction

Planned Parenthood can’t show class-action harm, filing says

A preliminary injunction blocking the state from cutting off Medicaid payments for Planned Parenthood services obtained by three women who are challenging the cutoff in a lawsuit shouldn't be applied to anyone else, the Arkansas attorney general's office argued Monday.

The state attorneys argued that there is no proof that a class represented by the three women would be "irreparably harmed" by waiting for a resolution of the suit. They also argued that the court lacks jurisdiction to expand the injunction while it is on appeal to the 8th U.S. Circuit Court of Appeals in St. Louis.

U.S. District Judge Kristine Baker of Little Rock on Oct. 2 granted the three anonymous women a preliminary injunction that prevents their Medicaid funds for Planned Parenthood services from being discontinued until their lawsuit is decided. Then on Jan. 25, Baker granted class-action status to the lawsuit, allowing the women to represent a class of perhaps thousands of Medicaid recipients in Arkansas who use Planned Parenthood services.

The women and Planned Parenthood of the Heartland, which operates clinics in Little Rock and Fayetteville, want Baker to include in the injunction all other Medicaid recipients in Arkansas who use the clinics' services.

Arkansas Solicitor General Lee Rudofsky and David Sterling, chief counsel for the Arkansas Department of Human Services, said in a response filed Monday that the plaintiffs months ago cited several problems that would arise without a blanket injunction, yet those "nearly insurmountable obstacles" haven't materialized. They noted that the plaintiffs bear the legal burden of proving they face irreparable harm without a blanket injunction.

Among the obstacles the plaintiffs cited in late September and early October were that Medicaid patients would lose access to family planning and other health services offered by Planned Parenthood, that they would lose access to timely services offered by other providers, and that some Medicaid patients would be forced to continue receiving Planned Parenthood services at substantially higher costs. The plaintiffs also said the clinics in Little Rock and Fayetteville would be forced to turn away hundreds of Medicaid patients, the state attorneys reminded the court.

"The Court relied heavily on those statements ... in concluding that it should grant the extraordinary relief of a preliminary injunction," the state attorneys argued. "Since that time, for the last six months, DHS has only been required to reimburse Planned Parenthood for Medicaid services provided to those three patients; DHS has not been required to make (and has not made) such reimbursements to Planned Parenthood for any other Medicaid patients."

They said that "within an hour" of Baker issuing an injunction for the three women, Planned Parenthood "told the public the exact opposite of what it had been representing to the Court. Specifically ... PPH made crystal clear it intended to keep serving ... at no cost" the 99 percent of Medicaid patients not included in the narrow injunction.

They cited statements from Suzanna de Baca, president and chief executive officer of Planned Parenthood of the Heartland, reassuring the public that the organization will meet patients' health care needs "regardless of their ability to pay."

State attorneys said Medicaid patients continue to pay nothing for Medicaid-eligible services at the clinics and haven't experienced reduced or altered services. They said Planned Parenthood of the Heartland hasn't reduced its hours or staffing, and has continued to advertise on its website that it accepts Medicaid.

"This, of course, explains why PPH has not provided the declaration of a single class member who has had to use another provider and either could not find one or could not easily obtain the services from the other provider," they wrote.

They said Medicaid reimbursements represent about $50,000 annually, or less than 1.25 percent of Planned Parenthood of the Heartland's "multimillion-dollar income."

The state attorneys argued that "courts in the 8th Circuit will not issue an injunction absent evidence of class-wide irreparable harm."

The state's appeal of the Oct. 2 injunction, which involves many of the same issues in the plaintiffs' motion to expand the injunction, is still pending before the 8th Circuit, the attorneys noted.

Gov. Asa Hutchinson announced in August that the state would end the payments because of videos that had been released by an anti-abortion group purporting to show that Planned Parenthood clinics in other states had profited from allowing patients to donate fetal tissue to medical research after abortions.

Medicaid funds cannot be used to pay for most abortions in Arkansas, but the state has reimbursed Planned Parenthood for services such as birth-control counseling, cancer screening and pregnancy testing. Those services cost the state's Medicaid program about $51,000 in the fiscal year that ended June 30, 2015.

Metro on 04/12/2016

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