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Obama administration warns states that Medicaid cuts to abortion providers could violate federal law

In a letter sent Tuesday, the Obama administration warned officials in every state that efforts to cut abortion providers out of Medicaid could violate federal law, the Washington Post reports.


Since July, 24 states have taken action against Planned Parenthood following the release of a series of misleading videos targeting the organization's fetal tissue donation program. According to the Post, multiple state investigations have cleared the organization of any wrongdoing.

Of those 24 states, 10 have moved to terminate the organization's Medicaid funding. The 10 states include Alabama, Arkansas, Arizona, Florida, Louisiana, Kansas, Missouri, Oklahoma, Texas and Wisconsin (Sun, Washington Post, 4/19). In response, Planned Parenthood filed suit against multiple states, including Alabama, Arkansas, Louisiana and Texas (Armour, Wall Street Journal, 4/19).

Prior to this latest letter, the Obama administration in August 2015 issued warnings to specific states that had moved to halt Planned Parenthood's Medicaid funding in the wake of the videos' release (Women's Health Policy Report, 8/13/15). According to the Post, the latest letter marks the first time CMS has issued such a warning to all states collectively (Washington Post, 4/19).

Warning letter

In the warning letter, CMS noted that federal Medicaid law stipulates that beneficiaries may seek services from any qualified provider (Wall Street Journal, 4/19).

According to the agency, states may only exclude a provider from the Medicaid program if the provider cannot offer covered health care services or is unable to bill services appropriately. CMS explained that states may not exclude a qualified provider for other reasons, and states are obligated to treat all qualified providers offering similar services equitably (Washington Post, 4/19). CMS stated that excluding an organization because it provides abortion care could violate Medicaid law because it prevents beneficiaries from accessing health care from their preferred provider (Wall Street Journal, 4/19).

Marissa Padilla, a spokesperson for HHS, said, "CMS is sending a letter to all states to ensure they have a clear understanding of their obligation to follow longstanding Medicaid law guaranteeing that beneficiaries have the right to receive covered services, including family planning services, from any qualified and willing provider of their choice" (Washington Post, 4/19).

CMS in the letter stated, "Providing the full range of women's health services neither disqualifies a provider from participating in the Medicaid program, nor is the provision of such services inconsistent with the best interests of the beneficiary, and shall not be grounds for a state's action against a provider in the Medicaid program."

According to the Wall Street Journal, CMS also has issued individual warnings to states that have moved to exclude Planned Parenthood from their Medicaid programs.

Next steps

Should states move ahead with their defunding efforts, CMS may send a pre-compliance warning letter, the Journal reports. That letter would be followed by a notice informing a state of potential repercussions, at which point that state can file an appeal.

The federal government has not yet sued a state regarding the latest cuts. However, the Department of Justice has filed statements of interest in Planned Parenthood's case against Louisiana (Wall Street Journal, 4/19).