Inside conservative activist Leonard Leo’s long campaign to gut Planned Parenthood

A federal lawsuit in Texas towards Planned Parenthood has an online of ties to conservative activist Leonard Leo, whose decades-long effort to steer the U.S. courtroom system to the suitable overturned Roe v. Wade, yielding the largest 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 swimsuit alleges the Planned Parenthood Federation of America and three Planned Parenthood associates defrauded the Texas and Louisiana Medicaid packages by amassing $17 million for providers offered whereas it fought state efforts to take away it as an accredited supplier.

The swimsuit 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 keeping with a movement that legal professionals for the whistleblower filed in federal courtroom in 2023.

The lawsuit builds on efforts over years by the spiritual 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 way in which for bans or extreme restrictions in 20 states. The courtroom problem in Texas demonstrates how the forces behind the top 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 lawyer common, and the decide—in keeping with a KFF Health News assessment of tax data, courtroom paperwork from a number of lawsuits, statements to lawmakers, and web site archives.

Leo offered authorized counsel to the anti-abortion group at its heart, and he has monetary and different connections to Paxton.

They filed the case in federal courtroom in Amarillo, Texas, the place Matthew Kacsmaryk is the one decide. 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 presently serves as co-chair.

Kacsmaryk’s rulings have curtailed entry to reproductive well being for the reason that Senate confirmed him in 2019. He suspended the FDA’s approval of mifepristone, a drug utilized in remedy abortion, propelling the difficulty to the Supreme Court, which finally threw out the case. In one other case, Kacsmaryk dominated to restrict younger folks’s entry to contraception 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 courtroom 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 packages 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 criticism.

The lawsuit’s origins return a decade. The nameless whistleblower, between 2013 and 2015, “performed an undercover investigation to find out whether or not Planned Parenthood’s fetal tissue procurement practices have been persevering with, and in the event that they have been authorized and/or moral,” in keeping with the whistleblower’s criticism 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 undertaking is a 30-month-long investigative journalism examine by The Center for Medical Progress, documenting how Planned Parenthood sells the physique elements of aborted infants,” the group states on its web site.

In a November 2022 courtroom order, Kacsmaryk mentioned the personal occasion initiating the lawsuit is “the president of CMP,” the title Daleiden held at the moment, in keeping 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 cannot pay for abortions except the being pregnant threatens the lifetime of a girl or is the results of rape or incest, however this system reimburses for different care comparable 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 offered 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 offered sufferers with greater than 86,000 exams 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 those providers and extra are in danger on this politically motivated lawsuit,” Linton mentioned. The lawsuit’s allegations “are false. Planned Parenthood didn’t commit Medicaid fraud.”

Linton has mentioned the lawsuit’s function is evident: “making an attempt to close Planned Parenthood down.”

Texas terminated Planned Parenthood’s Medicaid participation in March 2021. Until then, associates “have been entitled to obtain 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 courtroom 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 keeping with paperwork produced as a part of a separate lawsuit Planned Parenthood filed in federal courtroom 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 a minimum of a decade to when the previous state senator and rising conservative star was about to start his first time period as lawyer common.

In 2014, Leo, then govt vp of the Federalist Society, was a uncommon non-Texan named to Paxton’s lawyer common transition advisory group.

Tax filings present that the Concord Fund, one in all a number of Leo-linked teams that spend cash to affect elections and are not 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 “with out advantage,” mentioned Jacob Elberg, a professor at Seton Hall Law School and an knowledgeable in well being care fraud.

The legislation is meant for conditions “the place primarily somebody submits a declare for fee or retains cash that they are not entitled to the place they’ve info that the federal government does not have,” Elberg mentioned. “And they primarily know that if the federal government knew the reality, the federal government would not pay them or can be demanding a refund.”

But with Planned Parenthood, “all the pieces concerned right here occurred out within the open,” Elberg mentioned. “They have been submitting payments and the federal government knew what was happening and was paying these payments.”

The plaintiffs’ arguments are a “tortured use” of the False Claims Act, mentioned Sarah Saldaña, a former U.S. lawyer for the Northern District of Texas.

“Things like this, which have these apparent political overtones, are inclined to undermine additional the view of the general public of the judicial courts system,” Saldaña mentioned.

The workplace of the lawyer common didn’t reply to requests for remark.

Anti-abortion teams assist the Paxton lawsuit despite the fact that abortion is actually outlawed within the Lone Star State. Planned Parenthood “continues to be a pro-abortion group,” mentioned John Seago, president of Texas Right to Life. Even although Planned Parenthood offers different care, “all of these providers are tainted by their pro-abortion mindset,” he mentioned.

“Planned Parenthood is a hazard to Texans. We want that Planned Parenthood did not have a single location inside our state,” Seago mentioned. “Whenever the state pays Planned Parenthood to do one thing, even when it is a good service, we’re increase their model and giving them extra attain 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 keeping with its most up-to-date annual report.

The marketing campaign towards 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 proof I’m gathering deeply implicates Planned Parenthood associates throughout the nation in a number of felonies and might set off extreme authorized and monetary penalties for PP and their associates, whereas offering new justifications for state defunding efforts and turning public opinion towards Planned Parenthood and abortion,” Daleiden wrote in a May 2013 electronic 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 listening to, he mentioned “the true abomination in all of that is the establishment of abortion.”

“We are rightfully horrified by what we have seen on these movies,” Paxton mentioned. “However these movies additionally function a bigger reminder that, as a society, we have turned a blind eye to the grotesque horrors that happen in abortion clinics throughout America each single day. They remind us that this trade as an entire has misplaced the angle of humanity.”

Planned Parenthood denied promoting fetal tissue and different claims within the movies, a few of which contained graphic footage. It mentioned the movies have been “misleading” 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 keeping with the Center for Medical Progress’ web site, and Daleiden’s electronic mail correspondence and different paperwork produced as a part of the separate lawsuit in federal courtroom in California.

The July 2018 doc filed as a part of the litigation in California describes emails between Leo and Daleiden as “offering authorized communication with counsel relating to authorized planning” and “for counsel to supply authorized recommendation relating to investigative journalism strategies and the legality of fetal tissue procurement practices,” amongst different descriptions. Daleiden despatched one electronic mail to Leo “relating to authorized 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’ legal professionals acknowledged “CMP was receiving authorized recommendation” from Leo, in addition to different conservative legal professionals and organizations. Lawyers representing the middle and Daleiden in a December 2018 authorized submitting mentioned Leo “offered authorized recommendation on how to make sure profitable prosecutions of the felony actors which CMP recognized.”

In its protection, Planned Parenthood has mentioned it billed the Texas Medicaid program for reimbursement for “lawfully offered” providers from February 2017 to March 2021 as a taking part 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 mentioned the state was prohibited “from suspending Medicaid funds to [Planned Parenthood Gulf Coast] for providers rendered to Medicaid beneficiaries.”

The fifth Circuit Court of Appeals in November 2020 vacated the Texas and Louisiana injunctions, however the courtroom 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 courtroom ruling.

Texas and the whistleblower argue that, as soon as the courtroom injunctions have been lifted, Planned Parenthood’s termination from every state’s Medicaid program grew to become efficient years earlier—2015 in Louisiana and 2017 in Texas—as a result of dates that state officers gave clinics remaining discover.

Planned Parenthood has argued that it’s beneath no obligation to return funds obtained whereas injunctions have been in place. Kacsmaryk disagrees. In a just lately unsealed abstract judgment order within the case, the decide wrote that Planned Parenthood clinics “had an obligation to repay the federal government funds they obtained as a matter of legislation.”

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 acknowledged issues—which included the tainting of a possible jury pool or jeopardizing the protection of these concerned within the lawsuit—did not justify preserving the doc secret.

Kacsmaryk’s transient justification for sealing the doc, contained within the order itself, “was very skinny,” mentioned Katie Townsend, authorized director for the Reporters Committee for Freedom of the Press.

She mentioned his resolution to seal such an essential doc was “extremely uncommon” and “very troubling.”

“Those orders are nearly all the time fully public,” she mentioned.

What Paxton beneficial properties

Paxton has publicly toyed with the thought of pursuing federal workplace, and former President Donald Trump has mentioned he’d take into account him for U.S. lawyer common ought to Trump return to the White House.

For Republicans in Texas, there are political advantages to going after Planned Parenthood, mentioned Mark Jones, a political scientist at Rice University in Houston.

“Doing something punitive towards Planned Parenthood and something that would cut back the power of Planned Parenthood to be lively and efficient in Texas goes to be greeted with near-universal consensus inside the Republican major citizens,” Jones mentioned. “There’s no draw back 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 lawyer 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 lawyer common, matched by a $500,000 contribution from a political motion committee backed by conservative Texas billionaires, in keeping with Transparency U.S., a nonprofit that tracks spending in state politics.

RAGA has praised Leo’s function, calling him its “best champion.”

“Leonard Leo has helped form the trajectory of RAGA and the conservative authorized motion greater than anybody else. As RAGA’s best champion, Leonard Leo reimagined the function of the state lawyer common and promoted women and men devoted to the persistence of the rule of legislation and the unique that means of the Constitution,” reads a RAGA web site publish from 2019 that has since been deleted.

“You need entry to Leo as a result of Leo provides you entry to cash,” mentioned Chris Toth, former govt director of the National Association of Attorneys General.

In many conservative states like Texas, Toth mentioned, “the difficulty is worrying about getting primaried. And that’s the place enjoying good with Leonard Leo and the Concord Fund are available, as a result of for those who’re on their facet, mainly, you are going to haven’t any downside getting reelected.”

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 kinds of care beneath risk.

As an instance, some level to the Griswold v. Connecticut resolution from 1965, wherein the Supreme Court legalized the usage of contraception amongst married {couples}. The excessive courtroom 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 suppose tank, Leo criticized Griswold as a choice amounting to “the creation of rights discovered nowhere within the textual content or construction of the Constitution.”

The Planned Parenthood lawsuit in Texas is anticipated to go to trial, probably this yr. 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 better uncertainty about rights as soon as thought-about constitutionally assured. In a KFF ballot performed in February, one in 5 adults mentioned the suitable to make use of contraception is threatened and more likely to be overturned.

2024 KFF Health News. Distributed by Tribune Content Agency, LLC.