Supreme Court allows S. Carolina, other states to defund Planned Parenthood

SCOTUS allows S. Carolina, other states to defund Planned Parenthood.

Republicans scramble to pass Trump’s budget bill by July 4.

In a 6-3 decision along ideological lines, the Supreme Court has made it possible for South Carolina and other red states to cut off Medicaid funding to Planned Parenthood due to its status as an abortion provider.

The case before the court stemmed from a 2018 executive order by South Carolina Governor Henry McMaster. The order blocked any clinics that provide abortions from receiving Medicaid reimbursements on the grounds that, ” Payment of taxpayer funds to abortion clinics, for any purpose, results in the subsidy of abortion and the denial of the right to life”.

Planned Parenthood provides many other health services other than abortion. These include reproductive health services such as PAP smears, birth control, pre-natal care, cancer screenings, STI testing and many others. Many women use Planned Parenthood as a primary provider of routine gynecological care. One Planned Parenthood patient sued the state of South Carolina arguing that McMaster’s executive order violated the federal “free choice of provider” clause, which allows people insured by Medicaid to chose their own healthcare provider.

However, today’s ruling did not directly address whether a state could legally block Planned Parenthood or any other provider from receiving Medicaid reimbursements. Today, the six conservative justices merely ruled that an individual Medicaid beneficiary does not have the right to sue to force the state to honor the free provider of choice clause.

Republicans scramble to get Trump’s budget bill passed by July 4

President Trump has set congressional Republicans an ambitious goal of having his massive budget bill ready for him to sign by July 4. Senate Republicans continue to tinker with and retool the proposed text which was approved by House Republicans weeks ago.

Republicans are struggling to make the numbers work to accommodate competing demands. On the one hand, Trump is demanding to make his 2017 tax cuts permanent, which largely benefit the wealthy and will increase the federal deficit by over $2 trillion over the next 10 years. On the other hand, Trump is also demanding huge spending increases for the Pentagon and his deportation agenda. This leaves Republicans looking for ways to cut Medicaid in order to (somewhat) offset Trump’s demands for lower taxes and higher spending in other areas.

Republicans in both the Senate and House favor new Medicaid work requirements and registration hurdles, which could cause millions of Americans to lose their health coverage. Senate Republicans also sought to reduce federal Medicaid spending by capping state provider taxes. States collect provider taxes from revenue generated by health care providers (such as hospitals and long-term care facilities). These taxes help fund the states’ contributions to Medicaid. The federal government then matches the funds raised by the states, up to 90%. By capping these state provider taxes, the federal government can reduce its contributions to Medicaid in each state. States would then either have to seek health care funding from other sources to make up the shortfall, or be forced to cut Medicaid payouts.

Senate Parliamentarian scraps (some) Medicaid cuts

Republican Senators decided to lower the caps on provider taxes that could be charged, but only in states which had signed on to the Obamacare Medicaid expansion. States that did not sign on to the expansion (like Mississippi) would have their current provider tax rates frozen and would be unable to impose new taxes.

Today, the Senate Parliamentarian Elizabeth McDonough ruled that the provisions to cap or freeze state provider taxes cannot go through as written. This means Senate Republicans will have to retool their language once again.

Even once the Senate has finalized its text, House Republicans will still have to approve it before it can go to President Trump for signature. Changes made by the Senate are likely tee up fights among different House Republicans factions.