MO HealthNet Could Force Taxpayers to Pay for Abortions

January 30, 2008, JEFFERSON CITY, MO –  New rules proposed by the Department of Social Services for MO HealthNet could force taxpayers to fund abortions and compel private health insurance companies to reimburse family planning agencies that perform abortions.
 
At issue are proposed administrative rules that redefine “family planning services” so that private health carriers providing coverage on behalf of the state for the program shall be financially liable for payment of family planning services in accordance with “federal freedom of choice provisions.”  Statutes creating MO HealthNet state that the program shall pay for “Family planning as defined by federal rules and regulations; provided, however, that such family planning services shall not include abortions unless such abortions are certified in writing by a physician to the MO HealthNet agency that, in his professional judgment, the life of the mother would be endangered if the fetus were carried to term.” Section 208.152.1(11), RSMo 2007.

The proposed rule does not at all mirror this statutory language that protects unborn children and the taxpayers but instead states “If family planning services are sought out-of-network by a participant, the health carrier shall be financially liable for payment of those services in accordance with federal freedom of choice provisions.” Proposed 13 CSR 70.4.120(9)(E)2(K). The proposed rule referring to the “federal freedom of choice provision” is vague and seems to imply more coverage for abortion. It is unclear if the Department of Social Services is referring to the federal freedom of choice provision which was part of the Balanced Budget Act of 1997 or the Freedom of Choice Act. The federal “freedom of choice provision” was a rule implemented on the last day of President Bill Clinton’s administration. This provision requires state Medicaid programs to provide access to family planning services, including abortion, unless the state obtains a waiver exempting the state from the requirement. However, the second Bush administration withdrew this federal regulation.

Adding further confusion to this vagueness issue is the proposed Freedom of Choice Act (FOCA) introduced in Congress (http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=110_cong_bills&docid=f:s1173is.txt.pdf ). The Freedom of Choice Act would prevent government at any level from regulating abortion even nullifying the national ban on partial-birth abortion upheld by the United States Supreme Court in Gonzales v. Carhart, 550 US ___ (2007). FOCA would also invalidate “conscience rights” laws allowing doctors, nurses, or other state-licensed professionals, and hospitals or other health-care providers, to decline to provide or pay for abortions; stop parental consent or notification laws; and supersede laws which prohibit government funding of abortions. While FOCA has not been enacted into law the vague language could imply adherence to FOCA.

Because the Department of Social Services’ proposed rule requires private health carriers to reimburse “out of network”, these insurance companies could be forced to reimburse “out of network” Planned Parenthood and other abortion providers for abortions they perform.

Rep. Doug Ervin (R-Kearney) said, “Missouri lawmakers have made it clear that taxpayer funds should not go to paying for abortion services.  This proposed rule ignores the legislative intent behind MO HealthNet and begs the question why lawmakers have not had an opportunity to provide direction for Insure Missouri, instead giving that prerogative to unelected, unaccountable bureaucrats.”

“State bureaucrats should not be subverting the will of lawmakers who had made it crystal clear that they do not want abortions funded through state health insurance programs,” said Sam Lee of Campaign Life Missouri.

The Missouri Catholic Conference raised objections during consideration of MO HealthNet last year because it did not specifically state what services would be covered by the state. As a result the Department of Social Services is now free to propose its own rules governing MO HealthNet.

“Missouri citizens have made it clear that Missouri is a pro-life state and they do not want taxpayer-funded abortions,” said Deacon Larry Weber, Executive Director of the Missouri Catholic Conference. “Governor Blunt should immediately direct the Department of Social Services to remove the language which could force taxpayers to fund abortions through MO HealthNet.”

Should the governor choose not to direct the Department of Social Services to remove the language then another option would be for the legislature to either enact new legislation limiting the authority of the Department of Social Services to implement the MO HealthNet program through rules or to compel the Department of Social Services to withdraw the proposed rules through the appropriations process.

“Missouri tax paying citizens have every right to expect full protections of public funds when it comes to such deep and decisive moral issues. Such rule making begs intervention from our elected officials,” said Kerry Messer, lobbyist for the Missouri Baptist Convention, Christian Life Commission. “If any unelected state employee is determined to be deliberately trying to undermine Missouri’s pro-life statute, discipline should be expected.”

Department of Social Services Proposed Rules for MO HealthNet (PDF)