Updated at 6:45 p.m. ET
After more than a year of delays, Texas health officials are moving to block the women's health provider Planned Parenthood from receiving Medicaid funds beginning next month.
In October 2015, Texas officials told Planned Parenthood that the state intended to bar the organization from the public insurance program. Planned Parenthood responded with a lawsuit seeking an injunction against the state.
For more than a year, nothing seemed to be happening. Texas didn't follow through on its threat, and Planned Parenthood clinics — those that are still open after years of other budget cuts by the state Legislature — continued to provide services.
Then, on Tuesday, Texas Health and Human Services Inspector General Stuart Bowen sent a letter notifying Planned Parenthood that the state would cut off Medicaid funding in 30 days unless the organization requests an administrative hearing with the Texas Health and Human Services Commission in the next 15 days, The Texas Tribune reported.
The newspaper reported that Bowen's letter referenced undercover videos recorded in Houston by anti-abortion activists who said they showed a Planned Parenthood executive improperly offering to sell fetal tissue. A grand jury found no evidence of wrongdoing by Planned Parenthood and instead indicted two people who recorded the videos for tampering with a government record and illegally offering to purchase human organs, as The Two-Way has reported.
The indictments were later dismissed on technical grounds, as we also reported.
"Your misconduct is directly related to whether you are qualified to provide medical services in a professionally competent, safe, legal and ethical manner," Bowen wrote in the letter, according to the Tribune.
As in past cases in which states attempted to block funding to women's health providers, the final outcome of the state's move will be decided by the federal courts.
On Tuesday night, Planned Parenthood filed a notice in federal court in Austin adding an attorney to its 2015 complaint against the state. Officials from the organization told The New York Times they would continue to provide care to Medicaid patients and would seek an injunction in federal court to stop the state from blocking funds.
Earlier this month, the federal government finalized a regulation that "says states that award federally funded grants for women's health programs can't discriminate against Planned Parenthood," as NPR's Alison Kodjak reported. "The regulation doesn't name Planned Parenthood, but it was clear the rule was written with the organization in mind."
The organization says about 75 percent of the more than $500 million it receives each year from the U.S. government comes from Medicaid, as we have reported.
As NPR's Wade Goodwyn has reported, it is already against state and federal law for clinics that perform abortions to receive taxpayer dollars. Clinics that provide other health services — for example, HIV testing, cancer screenings and contraception — largely rely on those funds.
Most Planned Parenthood clinics in Texas do not provide abortion services.
Federal courts in other states have struck down multiple laws that attempted to block Medicaid dollars from clinics associated with organizations that provide abortions.
In 2012, a federal judge found an Indiana law that prohibited abortion providers from any state contracts, including state-administered federal funds, violated the Medicaid Act, which requires state Medicaid plans to "provide that ... any individual eligible for medical assistance ... may obtain such assistance from any institution, agency, community pharmacy, or person, qualified to perform the service."
This September, a federal judge found a similar law in Arkansas also violated Medicaid statutes protecting the rights of patients. And in October, a federal judge in Mississippi came to the same conclusion about a law passed by that state's Legislature, writing, "Essentially every court to consider similar laws has found that they violate § 1396a(a)(23) of Title 42 of the United States Code, the so-called 'Free Choice-of-Provider Provision.' "
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