A federal lawsuit in Texas towards Planned Parenthood has an internet of ties to conservative activist Leonard Leo, whose decades-long effort to steer the U.S. court docket system to the proper overturned Roe v. Wade, yielding the most important rollback of reproductive well being entry in half a century.
Brought by an nameless whistleblower and later joined by Texas Attorney General Ken Paxton, the go well with alleges the Planned Parenthood Federation of America and three Planned Parenthood associates defrauded the Texas and Louisiana Medicaid applications by amassing $17 million for providers supplied whereas it fought state efforts to take away it as an accepted supplier.
The go well with claims violations of the False Claims Act, an obscure however highly effective legislation defending the federal government from fraud, and seeks $1.8 billion in penalties from Planned Parenthood, in accordance with a movement that attorneys for the whistleblower filed in federal court docket in 2023.
The lawsuit builds on efforts over years by the non secular proper and politicians who oppose abortion to ship blows to Planned Parenthood — which offers sexual and reproductive well being care at almost 600 websites nationwide — now bolstered by Leo’s work reshaping the American judiciary.
Anti-abortion teams and their allies secured a generational victory in 2022 when the Supreme Court overturned Roe v. Wade, which ended the constitutional proper to abortion and paved the best way for bans or extreme restrictions in 20 states. The court docket problem in Texas demonstrates how the forces behind the tip of Roe threaten entry to different well being and household planning providers.
The Planned Parenthood clinics being sued don’t present abortions. They are in Texas and Louisiana, which banned almost all abortions, respectively, in 2021 and 2022.
Leo, an anti-abortion Catholic, is linked to the important thing gamers within the Texas lawsuit — the whistleblower plaintiff, an legal professional common, and the choose — in accordance with a KFF Health News assessment of tax data, court docket paperwork from a number of lawsuits, statements to lawmakers, and web site archives.
Leo supplied authorized counsel to the anti-abortion group at its middle, and he has monetary and different connections to Paxton.
They filed the case in federal court docket in Amarillo, Texas, the place Matthew Kacsmaryk is the one choose. He is a longtime member of the Federalist Society, the conservative authorized juggernaut for which Leo has labored for over 25 years in numerous capacities and at present serves as co-chair.
Kacsmaryk’s rulings have curtailed entry to reproductive well being because the Senate confirmed him in 2019. He suspended the FDA’s approval of mifepristone, a drug utilized in treatment abortion, propelling the problem to the Supreme Court, which in the end threw out the case. In one other case, Kacsmaryk dominated to limit young people’s access to birth control by means of a federal household planning program.
Leo didn’t reply to questions for this text and a spokesperson declined to remark. Through a court docket spokesperson, Kacsmaryk declined to remark for this text.
The nameless whistleblower in 2021 accused the Planned Parenthood Federation of America and Planned Parenthood associates of defrauding the Medicaid applications of Texas and Louisiana. Paxton, who has repeatedly acted to thwart abortion rights and joined the case in 2022, alleges within the lawsuit that clinics obtained funds they weren’t entitled to from Texas Medicaid from early 2017 to early 2021 because the state was pushing to finish Planned Parenthood’s standing as a Medicaid supplier. Louisiana and the Department of Justice haven’t joined the grievance.
The lawsuit’s origins return a decade. The nameless whistleblower, between 2013 and 2015, “conducted an undercover investigation to determine whether Planned Parenthood’s fetal tissue procurement practices were continuing, and if they were legal and/or ethical,” in accordance with the whistleblower’s grievance filed in 2021.
The clarification mimics how the Center for Medical Progress, a California-based anti-abortion group based by activist David Daleiden in 2013, has publicly described its work. “The Human Capital project is a 30-month-long investigative journalism study by The Center for Medical Progress, documenting how Planned Parenthood sells the body parts of aborted babies,” the group states on its website.
In a November 2022 court docket order, Kacsmaryk stated the personal occasion initiating the lawsuit is “the president of CMP,” the title Daleiden held at the moment, in accordance with a Center for Medical Progress tax submitting.
The Center for Medical Progress and Daleiden didn’t reply to requests for remark.
By legislation, federal funds can’t pay for abortions until the being pregnant threatens the lifetime of a girl or is the results of rape or incest, however this system reimburses for different care equivalent to contraception, screenings for sexually transmitted infections, and most cancers screenings. Medicaid, which offers well being protection for folks with low incomes, is collectively financed by states and the federal authorities.
According to its 2022-23 annual report, Planned Parenthood affiliate clinics supplied 9.13 million well being care providers to 2.05 million sufferers nationally in 2022. Testing and remedy for sexually transmitted infections accounted for about half of these providers, contraception amounted to 1 / 4, and abortions constituted 4%.
Planned Parenthood Gulf Coast, which operates clinics in Texas and Louisiana, is among the many branches Paxton and the whistleblower are suing. From July 2022 to June 2023, its clinics supplied sufferers greater than 86,000 assessments for sexually transmitted infections, 44,000 visits for contraception, and almost 7,000 most cancers screening and prevention providers, CEO Melaney Linton advised KFF Health News.
“All of these services and more are at risk in this politically motivated lawsuit,” Linton stated. The lawsuit’s allegations “are false. Planned Parenthood did not commit Medicaid fraud.”
Linton has stated the lawsuit’s purpose is clear: “trying to shut Planned Parenthood down.”
Texas terminated Planned Parenthood’s Medicaid participation in March 2021. Until then, associates “were entitled to receive reimbursement” for providers to Medicaid sufferers as a result of their supplier agreements with Texas’ Medicaid program have been legitimate, attorneys for the Planned Parenthood clinics wrote in a February 2023 court docket submitting in assist of their movement for abstract judgment.
Louisiana has not eliminated Planned Parenthood from its Medicaid program.
Leo served as authorized counsel to the Center for Medical Progress, in accordance with paperwork produced as a part of a separate lawsuit Planned Parenthood filed in federal court docket in California towards the anti-abortion group. Among these, a July 2018 doc lists 25 emails Leo and Daleiden traded in June and July 2015, together with within the days earlier than the anti-abortion group launched its first video.
Paxton’s ties to Leo could be traced again no less than a decade to when the previous state senator and rising conservative star was about to start his first time period as legal professional common.
In 2014, Leo, then govt vp of the Federalist Society, was a uncommon non-Texan named to Paxton’s legal professional common transition advisory workforce. Tax filings present that the Concord Fund, considered one of a number of Leo-linked teams that spend cash to affect elections and aren’t required to reveal their donors, gave $20.3 million from July 2014 by means of June 2023 to the Republican Attorneys General Association, the political nonprofit that works to elect Republicans as states’ prime legislation enforcement officers. Known as RAGA, the group funneled greater than $1.2 million to Paxton’s marketing campaign over three election cycles from 2014 to 2022, Texas marketing campaign finance data present.
Texas authorities officers knew the state was reimbursing Planned Parenthood clinics for medical providers from 2017 to 2021, which renders the state’s argument that clinics violated the False Claims Act “without merit,” stated Jacob Elberg, a professor at Seton Hall Law School and an knowledgeable in well being care fraud.
The legislation is meant for conditions “where essentially someone submits a claim for payment or keeps money that they’re not entitled to where they have information that the government doesn’t have,” Elberg stated. “And they essentially know that if the government knew the truth, the government wouldn’t pay them or would be demanding money back.”
But with Planned Parenthood, “everything involved here happened out in the open,” Elberg stated. “They were submitting bills and the government knew what was going on and was paying those bills.”
(Oona Tempest/KFF Health News)
The plaintiffs’ arguments are a “tortured use” of the False Claims Act, stated Sarah Saldaña, a former U.S. legal professional for the Northern District of Texas.
“Things like this, which have these obvious political overtones, tend to undermine further the view of the public of the judicial courts system,” Saldaña stated.
The workplace of the legal professional common didn’t reply to requests for remark.
Anti-abortion teams assist the Paxton lawsuit although abortion is basically outlawed within the Lone Star State. Planned Parenthood “is still a pro-abortion organization,” stated John Seago, president of Texas Right to Life. Even although Planned Parenthood offers different care, “all of those services are tainted by their pro-abortion mindset,” he stated.
“Planned Parenthood is a danger to Texans. We wish that Planned Parenthood didn’t have a single location within our state,” Seago stated. “Whenever the state pays Planned Parenthood to do something, even if it’s a good service, we are building up their brand and giving them more reach into our Texas communities.”
Roughly three dozen Planned Parenthood clinics in Texas proceed to supply non-abortion providers like contraception and STI screenings. The $1.8 billion the whistleblower is in search of is equal to just about 90% of Planned Parenthood’s annual income, in accordance with its most recent annual report.
The Campaign Against Planned Parenthood
The Center for Medical Progress was little identified in 2015 when it started releasing movies containing explosive allegations that Planned Parenthood was illegally promoting tissue from aborted fetuses, which Planned Parenthood denies.
The group and Daleiden had ties to highly effective anti-abortion organizations. They embody Live Action, the place Daleiden labored earlier than creating the Center for Medical Progress, and Operation Rescue, the Kansas-based group that staged demonstrations towards George Tiller’s abortion clinic in that state earlier than a gunman killed the doctor in 2009.
“The evidence I am gathering deeply implicates Planned Parenthood affiliates across the country in multiple felonies and can trigger severe legal and financial consequences for PP and their associates, while providing new justifications for state defunding efforts and turning public opinion against Planned Parenthood and abortion,” Daleiden wrote in a May 2013 e-mail produced as a part of the litigation Planned Parenthood introduced in California. The topic line: “Meeting to Take Down PP.”
Texas tried to take away Planned Parenthood clinics from its Medicaid program following the middle’s launch of the undercover movies, a transfer that was half of a bigger political firestorm. Roughly a dozen states launched investigations into the reproductive well being supplier, and Republicans in Congress renewed calls to strip Planned Parenthood of presidency funding.
Paxton made his emotions clear about abortion as he pursued an investigation of Planned Parenthood in Texas. During a July 29, 2015, legislative hearing, he stated “the true abomination in all of this is the institution of abortion.”
“We are rightfully horrified by what we’ve seen on these videos,” Paxton stated. “However these videos also serve as a larger reminder that, as a society, we’ve turned a blind eye to the gruesome horrors that occur in abortion clinics across America every single day. They remind us that this industry as a whole has lost the perspective of humanity.”
Planned Parenthood denied promoting fetal tissue and different claims within the movies, a few of which contained graphic footage. It stated the movies have been “deceptive” and closely edited to be deceptive. A grand jury in Texas cleared Planned Parenthood of wrongdoing.
Daleiden labored on the middle’s “Human Capital Project” for years, receiving recommendation from Leo and his associates, in accordance with the Center for Medical Progress’ web site, and Daleiden’s e-mail correspondence and different paperwork produced as a part of the separate lawsuit in federal court docket in California.
The July 2018 doc filed as a part of the litigation in California describes emails between Leo and Daleiden as “providing legal communication with counsel regarding legal planning” and “for counsel to provide legal advice regarding investigative journalism methods and the legality of fetal tissue procurement practices,” amongst different descriptions. Daleiden despatched one e-mail to Leo “regarding legal planning” on July 13, 2015, the day earlier than the Center for Medical Progress launched its first video.
A November 2018 letter from the Center for Medical Progress’ attorneys said “CMP was receiving legal advice” from Leo, in addition to different conservative attorneys and organizations. Lawyers representing the middle and Daleiden in a December 2018 authorized submitting stated Leo “provided legal advice on how to ensure successful prosecutions of the criminal actors which CMP identified.”
In its protection, Planned Parenthood has stated it billed the Texas Medicaid program for reimbursement for “lawfully provided” providers from February 2017 to March 2021 as a collaborating Medicaid supplier within the state.
In 2015 and 2017, federal courts in Louisiana and Texas blocked these states from terminating Planned Parenthood’s Medicaid supplier agreements. Judge John deGravelles of the U.S. District Court for the Middle District of Louisiana stated the state was prohibited “from suspending Medicaid payments to [Planned Parenthood Gulf Coast] for services rendered to Medicaid beneficiaries.”
The fifth Circuit Court of Appeals in November 2020 vacated the Texas and Louisiana injunctions, however the court docket by no means weighed in on clawing again Medicaid funds that had been paid to clinics. Texas terminated Planned Parenthood in March 2021, following a state court docket ruling.
Texas and the whistleblower argue that, as soon as the court docket injunctions have been lifted, Planned Parenthood’s termination from every state’s Medicaid program turned efficient years earlier — 2015 in Louisiana and 2017 in Texas — because of the dates that state officers gave clinics last discover.
Planned Parenthood has argued that it’s below no obligation to return funds obtained whereas injunctions have been in place. Kacsmaryk disagrees. In a lately unsealed abstract judgment order within the case, the choose wrote that Planned Parenthood clinics “had an obligation to repay the government payments they received as a matter of law.”
The order was unsealed after attorneys for the Reporters Committee for Freedom of the Press intervened. The committee argued the general public has a presumptive and constitutional proper to entry judicial data, and that Kacsmaryk’s said issues — which included the tainting of a possible jury pool or jeopardizing the security of these concerned within the lawsuit — didn’t justify conserving the doc secret.
Kacsmaryk’s temporary justification for sealing the doc, contained within the order itself, “was very thin,” stated Katie Townsend, authorized director for the Reporters Committee for Freedom of the Press.
She stated his choice to seal such an essential doc was “highly unusual” and “very troubling.”
“Those orders are almost always completely public,” she stated.
(Oona Tempest/KFF Health News)
What Paxton Gains
Paxton has publicly toyed with the concept of pursuing federal workplace, and former President Donald Trump has stated he’d consider him for U.S. attorney general ought to Trump return to the White House.
For Republicans in Texas, there are political advantages to going after Planned Parenthood, stated Mark Jones, a political scientist at Rice University in Houston. “Doing anything punitive against Planned Parenthood and anything that would reduce the ability of Planned Parenthood to be active and effective in Texas is going to be greeted with near-universal consensus within the Republican primary electorate,” Jones stated. “There’s no downside to it.”
The Republican Attorneys General Association, which might settle for limitless political donations that it distributes to candidates, is a Paxton supporter. Campaign finance data present it gave greater than $730,000 to Paxton’s legal professional common campaigns in 2014 and 2018.
Tax filings present that the Marble Freedom Trust, a political nonprofit the place Leo serves as trustee and chair, gave the Concord Fund $100.9 million from May 2020 by means of April 2023. During the 2022 election cycle, the Concord Fund gave $6.5 million to RAGA, which then contributed $500,000 to Paxton’s marketing campaign. It was tied as the best contribution to the Texas legal professional common, matched by a $500,000 contribution from a political motion committee backed by conservative Texas billionaires, in accordance with Transparency USA, a nonprofit that tracks spending in state politics.
RAGA has praised Leo’s position, calling him its “greatest champion.”
“Leonard Leo has helped shape the trajectory of RAGA and the conservative legal movement more than anyone else. As RAGA’s greatest champion, Leonard Leo reimagined the role of the state attorney general and promoted men and women dedicated to the persistence of the rule of law and the original meaning of the Constitution,” reads a RAGA web site publish from 2019 that has since been deleted.
“You want access to Leo because Leo gives you access to money,” stated Chris Toth, former govt director of the National Association of Attorneys General.
In many conservative states like Texas, Toth stated, “the issue is worrying about getting primaried. And that is where playing nice with Leonard Leo and the Concord Fund come in because if you’re on their side, basically, you’re going to have no problem getting reelected.”
The Concord Fund gave $4 million to RAGA between July 1, 2022, and June 30, 2023, 4 instances what it gave the prior fiscal 12 months.
Abortion rights supporters have warned that they anticipate ongoing reproductive well being battles in Texas and past, with entry to contraception, fertility providers, and different forms of care below menace.
As an instance, some level to the Griswold v. Connecticut choice from 1965, through which the Supreme Court legalized using contraception amongst married {couples}. The excessive court docket dominated {that a} state legislation violated a constitutional proper to privateness, a rationale that was central to Roe v. Wade eight years later.
In a 2017 speech on the Acton Institute, a conservative assume tank, Leo criticized Griswold as a call amounting to “the creation of rights found nowhere in the text or structure of the Constitution.”
The Planned Parenthood lawsuit in Texas is predicted to go to trial, probably this 12 months. The central query is whether or not Planned Parenthood knowingly withheld cash owed to the federal government.
All the whereas the general public is expressing larger uncertainty about rights as soon as thought of constitutionally assured. In a KFF poll conducted in February, 1 in 5 adults stated the proper to make use of contraception is threatened and prone to be overturned.
Fewer than half of adults thought of it to be safe.
Rachana Pradhan:
rpradhan@kff.org,
@rachanadpradhan
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