Tennessee is pushing to bar abortion providers from its Medicaid program in the latest effort to scale back the influence of reproductive health-care giant Planned Parenthood.
The move signals growing GOP interest in using administrative means to rein in providers that offer abortion and underscores state confidence in the Trump administration’s friendliness to the conservative policy priority.
If approved, Tennessee’s attempt—and others like it—would dramatically alter the landscape of federal family planning coverage. Medicaid is the primary public payer for such services, covering up to 75 percent of birth control services and supplies in the U.S. in 2015, according to the Kaiser Family Foundation. And the health insurance program for the poor funds about half of Planned Parenthood patients’ care, the PP Action Fund says.
Rallying cries to defund Planned Parenthood faltered in 2017 during the congressional Obamacare repeal battle. But the CMS has since offered cues it would be willing to allow states to block providers from safety net health-care coverage.
The agency reversed an Obama-era letter earlier this year that explicitly prohibited disqualifying family planning providers from Medicaid because of the services they offer, touting its decision as protecting conscience rights and granting states more flexibility.
“Efforts like these should continue to gain traction among Republicans in the coming years, as repeated efforts to achieve this policy goal at the federal level have fallen short, even with the party controlling both chambers of Congress,” Brian Rye, a Bloomberg Intelligence health-care analyst, told Bloomberg Law in an email.
The provider received $543.7 million in government taxpayer money in fiscal 2016, according to its annual report, although federal Medicaid funds generally can’t be used to cover most abortions under the Hyde Amendment.
Tennessee Wants to Boot Abortion Providers
The Volunteer State is asking the Centers for Medicare & Medicaid Services to block providers that performed more than 50 abortions in the past year from its Section 1115 Medicaid waiver, according to a spokeswoman for the state’s Medicaid program TennCare.
Public comments on the request close Sept. 23.
A spokesman for the federal Medicaid agency told Bloomberg Law the CMS does not comment on pending waiver applications. But the CMS is working to review and process Section 1115 applications “as quickly as possible” and is taking steps to speed up the process, he added.
TennCare pays for health care for about 1.4 million people at a cost of about $12 billion per year, according to the state.
The National Association of Medicaid Directors declined to comment on the push.
Drumbeat of Attacks
Planned Parenthood sees the move as part of a drumbeat of Trump administration attacks on reproductive health-care access.
States like Tennessee and South Carolina, which has also sought to exclude abortion providers, are following Texas’s lead.
The Lone Star State was the first to oust Planned Parenthood from its Medicaid family planning program but has had to rely solely on state funds to support the program since 2013, when the Obama administration deemed the move unlawful and pulled federal funding. Texas doubled down in 2017 on its Healthy Texas Women waiver, asking the Trump administration for federal support.
Danielle Wells, assistant director of state advocacy media for Planned Parenthood Federation of America, told Bloomberg Law in a statement the three states’ efforts are “simply a backdoor attempt to block care at Planned Parenthood.
“State politicians, in lock step with the Trump-Pence administration, are bending the rules to take away women’s health and rights any way they can,” she added, pointing to birth control and cancer and STD screenings the provider offers.
Planned Parenthood receives funding from Bloomberg Philanthropies, the charitable organization founded by Bloomberg Law owner Michael Bloomberg.
The Heritage Foundation and other conservative groups have called for Planned Parenthood to be stripped of federal Medicaid reimbursements, naming it America’s leading abortion provider.
Heritage declined to comment on Tennessee’s request. Susan B. Anthony List and the National Right to Life Committee could not be reached for comment.