Florida Pushes Rule Allowing Medicaid Providers To Opt-Out Of Family Planning Services On Moral Or Religious Grounds

The 2010 Republican wave is bearing a multi-pronged attack on women’s reproductive rights. Pushing nearly 1,000 anti-choice bills through legislatures, Republican lawmakers across the country are finding significant success in demonizing Planned Parenthood. Indiana Gov. Mitch Daniels (R) recently beat out four GOP governors and House Republicans to make Indiana the first state to defund the health and family planning organization to the detriment of thousands. However, because providing family planning services is a mandated requirement for health providers, Indiana is running afoul of federal law and stands to lose $4 billion in Medicaid funding.

Seemingly undeterred by such consequences, Florida Gov. Rick Scott (R) and the GOP-led legislature are now attacking family planning through Medicaid. Earlier this month, Scott signed into law “a landmark Medicaid overhaul” that jeopardizes quality health care for thousands of Floridians. Now, the Florida Independent reports that the state’s Agency for Health Care Administration (AHCA) is moving forward with a new rule allowing Medicaid providers to opt out of providing family planning services — which includes birth control — on “moral or religious grounds.” Citing a federal provision that allows providers to opt out of “counseling or referral service” for similar reasons, AHCA and state Republicans want to exempt moral and religious objectors from providing family planning services entirely:

Florida’s Medicaid bill contains a list of required minimum benefits that should be covered by providers. Under the section for “family planning services and supplies” the bill’s sponsor added:

Pursuant to 42 C.F.R. s. 438.102, plans may elect to not provide these services due to an objection on moral or religious grounds, and must notify the agency of that election when submitting a reply to an invitation to negotiate.

The federal provision in questions reads:

(2) Subject to the information requirements of paragraph (b) of this section, an MCO, PIHP, or PAHP that would otherwise be required to provide, reimburse for, or provide coverage of, a counseling or referral service because of the requirement in paragraph (a)(1) of this section is not required to do so if the MCO, PIHP, or PAHP objects to the service on moral or religious grounds.

The provision was added to the state’s Medicaid bill at the request of Catholic Services, “which is looking to become a Medicaid provider.”

In defense of the radical rule, AHCA argues that if a plan elects not to provide family planning services, “the plan enrollees will have access to these very same services through fee-for-service provision outside of the plan.” However, as Florida Planned Parenthood policy director Judith Selzer notes, there is no provision in the bill that makes sure there is at least one provider of family planning in every region. As low-income Medicaid patients are already a “very vulnerable population,” the requirement to go outside of their provider network “makes it even less likely that they will get these important services.”

The new rule must still receive approval from the Centers for Medicare & Medicaid Services (CMS) and ACHA has until Aug. 1 to finalize the proposal. But given CMS’s reception to Indiana’s attempt to obstruct family planning services, the Florida GOP’s dogma may not fare so well.