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August 12, 2015; New England Journal of Medicine and the Wall Street Journal

Despite warnings from federal officials and strong support from the medical community, efforts to defund Planned Parenthood on a state-by-state basis continued this past week.

The respected New England Journal of Medicine published a strong endorsement of the use of fetal tissue in medical research. R. Alta Charo, J.D., Warren P. Knowles Professor of Law and Bioethics at the University of Wisconsin Law School, stressed the importance of fetal tissue in medical research.

We have a duty to use fetal tissue for research and therapy…Virtually every person in this country has benefited from research using fetal tissue. Every child who’s been spared the risks and misery of chickenpox, rubella, or polio can thank the Nobel Prize recipients and other scientists who used such tissue in research yielding the vaccines that protect us (and give even the unvaccinated the benefit of herd immunity). This work has been going on for nearly a century, and the vaccines it produced have been in use nearly as long. Any discussion of the ethics of fetal tissue research must begin with its unimpeachable claim to have saved the lives and health of millions of people.

In a separate editorial, NEJM stood firmly behind Planned Parenthood:

It is shameful that a radical anti-choice group whose goal is the destruction of Planned Parenthood continues to twist the facts to achieve its ends. We thank the women who made the choice to help improve the human condition through their tissue donation; we applaud the people who make this work possible and those who use these materials to advance human health. We are outraged by those who debase these women, this work, and Planned Parenthood by distorting the facts for political ends.

Planned Parenthood’s mobilized its Clergy Advocacy Board to counter the attacks on its ethics. The board of religious leaders issued a statement defending the organizations’ practices. “Planned Parenthood offers the opportunity for women to choose to donate fetal tissue for research purposes,” the clergy statement said. “Research using fetal tissue saves hundreds of thousands of lives worldwide every year. The scriptures of Judaism, Christianity and Islam strongly and repeatedly condemn dishonesty and hate.”

And the Obama administration took steps to counter state actions defunding PP. Health and Human Services (HHS) Secretary Sylvia Burwell explained her position at a recent congressional hearing, saying, “What I think is important is that our HHS funding is focused on issues of preventative care for women, things like mammograms and cancer prevention screenings.”

According to the Wall Street Journal:

The Centers for Medicare and Medicaid Services, a unit of (the US Department of Health and Human Services) HHS, has notified Alabama and Louisiana, which have taken action to terminate their Medicaid provider agreements with Planned Parenthood, that they may be in conflict with federal law…The agency said that, by restricting providers, women could lose access to critical preventive care, such as cancer screenings.

HHS said it provided both states with guidance it released in a June 2011 memo, which says states aren’t permitted to exclude providers from Medicaid solely on the basis of the range of medical services they provide. The memo says states may exclude providers under certain circumstances, such as when providers commit fraud or certain criminal acts.

HHS’s challenge did not stop two additional states from moving forward with efforts to defund Planned Parenthood. According to The Hill, Arkansas Governor Asa Hutchinson ordered the state’s health department to end Medicaid contracts with Planned Parenthood. “It is apparent,” he said, “that after the recent revelations on the actions of Planned Parenthood, that this organization does not represent the values of the people of our state and Arkansas is better served by terminating any and all existing contracts with them.”

In Utah, Gov. Gary Herbert took action to bring the number of states ending PP’s Medicaid funding to five. In his statement announcing his decision, he said:

The allegations against Planned Parenthood are deeply troubling. Current Utah state law prohibits the use of state funds to provide abortions by Planned Parenthood or any other organization. The federal government has provided grants to Planned Parenthood, distributed through the Utah Department of Health. These funds are also prohibited from being used to perform abortions. In light of ongoing concerns about the organization, I have instructed state agencies to cease acting as an intermediary for pass-through federal funds to Planned Parenthood.

Planned Parenthood is considering its next steps to challenge state actions, and additional states are weighing how they can limit PP. And while the political and legal chess match goes on, the availability of medical care for millions of women hangs in the balance. That is the bottom line, which cannot be forgotten in all the smoke and fire of this dispute.—Marty Levine