May was a devastating month for many Oklahomans. While most Oklahomans were preoccupied assisting those affected by storms, Oklahoma legislators used the waning days of the legislative session to revive and approve a measure targeting funding for family planning services provided by Planned Parenthood in Oklahoma. However, it appears likely that their shot drew a blank.
SB 900 passed during the final hours of the legislative session and was signed into law on May 29th. The legislation introduced as SB 900 bears no resemblance to the Act that became law. Initially SB 900 was a bill relating to inspections and investigations of hospice facilities. However, when it came out of conference committee in the final days of session, it had mysteriously morphed into the Prioritization of Public Funding in the Purchasing of Family Planning and Counseling Services Act.
While SB 900 makes no explicit mention of withholding funds from Planned Parenthood, its intentions are clear by the way it prioritizes the administration of federal and state funds for family planning or counseling services in the following order:
- To public entities;
- To nonpublic hospitals, federally qualified health centers, and rural health clinics; and
- To nonpublic health providers that have as their primary purpose the provision of the primary health care services enumerated in 42 U.S.C., Section 254b(a)(1)
Some, including Rep. Doug Cox, believed that SB 900 is Oklahoma’s way to continue its assault on Planned Parenthood. Dr. Cox, who was vocal last year against the legislature’s attempt to pass a measure similar to SB 900, spoke out again this year saying that:
Although the words ‘Planned Parenthood’ are never specifically mentioned in the legislation, it is worded in such a way to restrict the use of ‘any expenditures or grants of public funds for family planning or counseling services by the State of Oklahoma shall be made in the following order of priority.’ Their ‘priority’ is such to effectively cut off all such funds that go to Planned Parenthood.
Yet even if the legislature’s evident intent was to deny family planning funding to Planned Parenthood, the legislation is unlikely to achieve its goals.
Federal funds for family planning services are allocated from Title X of the Public Health Service Act. The Oklahoma State Department of Health (OSDH) and the Oklahoma Health Care Authority (OHCA) both use Title X funding to offer family planning services.
OSDH offers family planning services through local county health departments, Variety Care, (a federally qualified health center), and Family Health Care Clinic in Bartlesville. These services are offered to both male and females of reproductive age and are not refused due to an inability to pay. OHCA administers family planning services through its SoonerPlan program. The program is available to Oklahoma residents (men and women) not enrolled in the regular SoonerCare program with an income less than 185 percent of the federal poverty level. SoonerPlan pays for a host of family planning services, including contraception, which can be received from any SoonerCare provider who offers family planning services.
SB 900 will not have any effect on the way in which OSDH expends Title X funds for family planning services since the recipients of the funds all fit within in one of the designated categories. Planned Parenthood facilities in Oklahoma are not recipients of Title X money from the state.
As for OHCA, it didn’t consider a hierarchy of paying claims prior to the passage of SB 900. OHCA administers Medicaid funds and must adhere to the Medicaid requirement of freedom of choice. This regulation states that:
Medicaid beneficiaries may obtain medical services “from any institution, agency, community pharmacy, or person, qualified to perform the service or services required . . . who undertakes to provide him such services.”
This federal regulation means that any willing provider of Medicaid services, excluding those that commit fraud or criminal acts, is entitled to payment and can’t be excluded because of the medical services they provide. Following SB 900 would put OHCA in direct conflict with this federal regulation because some Medicaid providers may not fit within the prioritized list. According to agency spokesman Carter Kimble, nothing will change as to the way a clean claim is paid going forward.
Planned Parenthood remains a vital provider of reproductive and women’s health services in Oklahoma. As Dr. Cox notes:
Planned Parenthood health centers in Oklahoma provide crucial services such as breast and cervical cancer screenings. Planned Parenthood may be the only place where some patients, particularly those in the low income bracket, can obtain these life-saving cancer screening exams.
While Oklahoma was successful last year in cutting funding from Planned Parenthood to provide services for the Women, Infant, and Children program, the most recent attempt to drain funding from the facilities for family planning services are likely to be unfruitful.
Gov. Fallin and the Republican leadership in the Oklahoma legislature were quite proud of their accomplishments this year, going so far as to give themselves an A grade. SB 900 is essentially ineffectual and it’s hard to believe anyone would be proud of producing meaningless legislation.