Planned Parenthood Ariz., Inc. v. Betlach
| Decision Date | 19 October 2012 |
| Docket Number | No. CV–12–01533–PHX–NVW.,CV–12–01533–PHX–NVW. |
| Citation | 899 F.Supp.2d 868 |
| Parties | PLANNED PARENTHOOD ARIZONA, INC.; Jane Doe # 1; Jane Doe # 2; Jane Doe # 3; Eric Reuss, M.D., Plaintiffs, v. Tom BETLACH, Director, Arizona Health Care Cost Containment System; Tom Horne, Attorney General, Defendants. |
| Court | U.S. District Court — District of Arizona |
OPINION TEXT STARTS HERE
Alice Clapman, Planned Parenthood Federation of America, Washington, DC, Andrew Beck, ACLU, Roger K. Evans, Planned Parenthood Federation of America, Susan Talcott Camp, American Civil Liberties Union, New York, NY, Daniel Benjamin Pasternak, Lawrence Jay Rosenfeld, Greenberg Traurig LLP, Daniel Joseph Pochoda, Kelly Joyce Flood, ACLU, Phoenix, AZ, for Plaintiffs.
Logan T. Johnston, Johnston Law Offices PLC, David Robert Cole, Thomas Matthew Collins, Office of the Attorney General, Phoenix, AZ, Catherine Glenn Foster, Steven Henry Aden, Alliance Defending Freedom, Washington, DC, for Defendants.
ORDER AND FINDINGS OF FACT AND CONCLUSIONS OF LAW
Before the Court is Plaintiffs' Motion for Preliminary Injunction (Doc. 6) and Defendants' Motion to Dismiss Counts I and II (Doc. 37). For the reasons below, the Plaintiffs' Motion for Preliminary Injunction will be granted, and the Defendants' Motion to Dismiss will be denied. This Order states the Court's findings of fact and conclusions of law under Fed.R.Civ.P. 52(a)(2).
I. BACKGROUNDA. The Challenged Arizona Act
Plaintiffs brought this action to enjoin the enforcement of Arizona Legislature HB 2800, 2nd Regular Session, 50th Legislature (2002) (“the Arizona Act”), which prohibits any health care provider who performs elective abortions from receiving Medicaid funding. A.R.S. § 35–196.05. The challenged portion of the Arizona Act provides:
This state or any political subdivision of this state may not enter into a contract with or make a grant to any person that performs nonfederally qualified abortions or maintains or operates a facility where nonfederally qualified abortions are performed for the provision of family planning services.
A.R.S. § 35–196.05(B). For the purposes of the Arizona Act, “nonfederally qualified abortion” is defined as “an abortion that does not meet the requirements for federal reimbursement under title XIX of the social security act.” A.R.S. § 35–196.05(F)(4). In turn, an abortion that does not meet the requirements for federal reimbursement is any abortion except where the pregnancy is the result of rape or incest, or threatens the life or health of the mother. Exec. Order No. 13,535, 75 Fed.Reg. 15, 599 (Mar. 24, 2010). The Arizona Act therefore prohibits any person or entity that performs abortions, outside of those exceptions, from participating in Medicaid. On May 4, 2012, Governor Jan Brewer signed the Arizona Act into law after the Act passed by wide margins in both houses of the Arizona Legislature. Though the Arizona Act was scheduled to take effect on August 2, 2012, the parties in this case stipulated to a temporary restraining order that delayed implementation and enforcement of the Act pending the Court's ruling on Plaintiffs' Motion. (Doc. 26.)
B. The Medicaid Program
The Medicaid program, established by Title XIX of the Social Security Act, 42 U.S.C. § 1396 et seq., is a cooperative federal-state program created to provide medical assistance to needy families and individuals. Under the Medicaid program, the federal government provides funds to states to offset some of the expense of furnishing medical services to low-income persons. The program is jointly financed by the federal and state governments, and states administer the program according to federal guidelines. 42 U.S.C. § 1396 et seq.;42 C.F.R. § 430.0. States are not required to participate in the federal Medicaid program. Once a state elects to participate in Medicaid, however, it must do so in accordance with federal statutes and regulations. 42 U.S.C. § 1396a(a)(1)-(83); Wilder v. Va. Hosp. Ass'n, 496 U.S. 498, 502, 110 S.Ct. 2510, 110 L.Ed.2d 455 (1990).
States that participate in the Medicaid program are required to develop a comprehensive plan for the provision of services that must be approved by the Secretary of Health and Human Services (“the Secretary”). 42 U.S.C. § 1396a(a); Wilder, 496 U.S. at 502, 110 S.Ct. 2510. The Secretary delegates power to review and approve plans to Regional Administrators of the Centers for Medicare and Medicaid Services (“CMS”). 42 C.F.R. § 430.15(b). CMS reviews the state plan to determine whether its provisions are consistent with federal policy. 42 C.F.R. § 430.14. CMS then exercises its delegated authority either to approve the state plan or to disapprove the plan after consulting with the Secretary. 42 C.F.R. § 430.15(b)-(c).
Central to the dispute in this case, among the requirements for states to participate in the Medicaid program, “[a] State plan for medical assistance must—provide that:”
(A) any individual eligible for medical assistance (including drugs) may obtain such assistance from any institution, agency, community pharmacy, or person, qualified to perform the service or services required (including an organization which provides such services, or arranges for their availability, on a prepayment basis), who undertakes to provide him such services, and
(B) an enrollment of an individual eligible for medical assistance in a primary care case-management system ... a Medicaid managed care organization, or a similar entity shall not restrict the choice of the qualified person from whom the individual may receive services under section 1396d(a)(4)(C) of this title.
42 U.S.C. § 1396a(a)(23). The Supreme Court has interpreted this freedom of choice provision to give Medicaid recipients“the right to choose among a range of qualified...
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