(Freedom.news) States don’t have much say in how Medicaid funds are spent or who can qualify for them, but one of the few powers they retain when it comes to managing an entitlement program that absorbs one-third of their budgets is deciding which healthcare facilities can participate in the program.
Now, it seems, even that power is under assault.
As reported by The Federalist, angered by what it no doubt views as an attack on a political ally, the Obama administration has warned the state of Texas that its recent decision to exclude Planned Parenthood from the Medicaid program “may be in conflict with federal law.”
Texas officials made their decision in October following revelations over the summer that some Planned Parenthood clinics likely violated federal statutes against mishandling fetal tissue and selling it for profit – activities that were uncovered by operatives working on behalf of the Center for Medical Progress.
The videos, you may recall, show Planned Parenthood officials admitting to conduct that violate state and federal laws governing abortion. But the Obama administration has vehemently defended the nation’s largest abortion provider. And given the fact that Texas is one massive Red State, the warning – given states authority to decide which providers get to participate in Medicaid reimbursement – seems extremely political in nature.
“The problem with all this, according to Obama administration officials, is that federal Medicaid law prohibits states from telling Medicaid enrollees—the patients—where they’re allowed to get healthcare services,” John Daniel Davidson, director of the Center for Health Care Policy at the Texas Public Policy Foundation in Austin, wrote in The Federalist. “Medicaid is an entitlement program, so anyone who’s enrolled is supposed to be able to go to ‘any qualified provider,’ that is, any provider approved to participate in the Medicaid program.”
And this is the rub, at least for administration officials, writes Davidson:
But states determine who’s a qualified provider, not the federal government. States might not be allowed to decide who’s eligible for Medicaid or what benefits Medicaid covers, but they do get to decide which providers in their state qualify to be in the program. That’s really one of the only things they get to decide about Medicaid.
In the state’s letter to Planned Parenthood Gulf Coast, Texas Office of Inspector General officials, who are handling the matter, said that the organization was “liable, directly or by affiliation, for a series of serious Medicaid violations.”
Davidson went on to note that the disapproval process for Medicaid providers on the state level is routine, and that is especially the case in Texas, which publishes a monthly roster of excluded health care providers – a roster that numbers in the thousands. That in and of itself makes the Obama administration threat appear even more political.
But there is another facet of the Texas action that could have wider implications, explains Davidson:
…[T]he Affordable Care Act requires states to exclude a provider or supplier from its Medicaid program if they have been excluded from Medicare or from a Medicaid program in another state (which means, in theory, all other states would have to exclude Planned Parenthood now that Texas has done so).
The threat of action, he notes further, is worrisome because should the Obama administration follow through, such action will further erode the traditional (and constitutional) concept of federalism – the relationship, as it pertains to division of power, between Washington, D.C., and state capitols.
Davidson says Texas officials will likely face threats of legal action, deprivation of funding and other punitive measures in the administration’s attempt to essentially force it to bend to the will of the White House.
“It’s going to take a state like Texas to stand up to all that,” he writes.
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See also:
http://thefederalist.com/2015/11/05/feds-try-to-force-planned-parenthood-on-texas-taxpayers/
http://www.texastribune.org/2015/10/28/feds-kicking-planned-parenthood-out-medicaid-may-b/
http://www.scribd.com/doc/285904000/Texas-to-cut-Planned-Parenthood-out-of-Medicaid