Medicaid funding for nonabortion services provided by Arkansas' two Planned Parenthood clinics remains unavailable after a federal judge refused Monday to grant the provider's latest request to restore the funding.
In 2015, U.S. District Judge Kristine Baker blocked the state from cutting off Medicaid funding for three women who sued over Gov. Asa Hutchinson's decision to sever the state's Medicaid contract with the provider.
Baker later expanded her order to prevent the state from cutting off funding for all Medicaid recipients in Arkansas who sought family planning and preventive health care services at the clinics. Abortion services already weren't covered by Medicaid.
But nearly a year ago, on Aug. 16, a divided three-judge panel of the 8th U.S. Circuit Court of Appeals in St. Louis vacated both of Baker's preliminary injunctions, which were based on the clinics' arguments that the termination violated the plaintiffs' rights to obtain health-care services from the provider of their choosing.
The 8th Circuit panel said that federal law doesn't create an enforceable federal right for individual patients.
That prompted Planned Parenthood to pursue a new preliminary injunction under alternative grounds. Those grounds -- that in denying the use of state and federal funds to cover services for poor and disabled people, the state was violating those people's equal protection rights guaranteed under the 14th Amendment, and that the termination was intended to penalize the provider for advocating for reproductive freedom and/or associating with abortion, in violation of the First Amendment -- were rejected by Baker late Monday afternoon.
Baker found that the clinics "have not met their burden of proof for a preliminary injunction on their constitutional claims."
She cited disagreement on similar First Amendment issues in courts across the country as preventing the plaintiffs from establishing they are likely to succeed on the retaliation claim. A likelihood of prevailing is a necessary condition for a preliminary injunction. She said the plaintiffs also haven't established a likely ultimate victory on their equal protection claims.
While the ruling prevents Planned Parenthood from obtaining immediate relief, the merits of the case are still pending.
Bettina Brownstein, one of Planned Parenthood's attorneys, said Monday evening that while attorneys are evaluating how to proceed next, "We are going to keep fighting. They're never going to beat us."
Planned Parenthood clinics in Arkansas -- one each in Little Rock and Fayetteville -- provide family planning services to men and women, including contraception and contraceptive counseling, screening for breast and cervical cancer, pregnancy testing and counseling, in addition to medication-induced abortion for women who are less than 10 weeks' pregnant.
In 2017, the two clinics provided over 1,000 health-care visits for more than 750 men, women and teens insured through Medicaid. That constituted about 20 percent of the clinics' patients, Baker noted.
The three women who were the original plaintiffs said they preferred to obtain services from the Planned Parenthood clinics over public health clinics because of convenience, ease in obtaining appointments, quick and reliable test results and because they like the atmosphere and staff, and the clinics' accommodations for their inflexible work schedules.
The governor's directive on Aug. 14, 2015, cited videos released nationally by the Center for Medical Progress that appeared to show that Planned Parenthood clinics in other states were violating medical guidelines and laws. However, governmental investigations later conducted in several states in response to the videos found no wrongdoing on Planned Parenthood's part.
Although Planned Parenthood initially planned to keep providing services to Medicaid patients in the hope of being reimbursed later, if it won the case, the provider's attorneys said the state made clear in January that the effort was futile, because the state was also cutting off Medicaid patients' ability to fill prescriptions or obtain test results resulting from the services, or to see follow-up specialists.
That led to the clinics' decision early this year to cease providing services for Medicaid patients.
Metro on 07/31/2018