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The Absurd Lawsuit That Could Bankrupt Planned Parenthood

An anti-abortion activist and Texas’s attorney general have teamed up to try to force the organization out of the state—and now an anti-abortion judge has advanced their cause.

An abortion rights activist holds a sign in support of Planned Parenthood at a rally at the Texas State Capitol
Jordan Vonderhaar/Getty Images
An abortion rights activist holds a sign in support of Planned Parenthood at a rally at the Texas State Capitol on September 11, 2021.

A decade-long campaign by Texas Republicans to punish Planned Parenthood and run it out of the state advanced this week, thanks to one of the most anti-abortion judges in the United States. U.S. District Judge Matthew Kacsmaryk on Monday ruled in favor of an anonymous anti-abortion activist who has sued Planned Parenthood and its Texas affiliates on dubious grounds, ordering a jury trial that may allow the activist to collect $1.8 billion in judgment from the organization—imperiling its very existence in the state.

Groomed by the Christian right, Kacsmaryk was appointed by President Donald Trump and began serving as a federal judge in the Northern District of Texas in 2019. Because he is the only judge serving this court, any case brought there will inevitably end up before him, which the right uses to its advantage. It’s called judge-shopping, and Kacsmaryk is one of the most prominent examples of it in the country: Conservatives bring their cases to his court to ensure their desired outcome. From his courtroom in Amarillo, Kacsmaryk wields disproportionate power over sexual and reproductive freedom in particular. He has sided with a Christian right group that says the abortion pill mifepristone harms doctors, and has invoked the anti-LGBTQ group Gays Against Groomers in a ruling favoring a Texas university president who banned drag on campus.

The lawsuit against Planned Parenthood that is now before Kacsmaryk concerns the claims of an anonymous “Alex Doe” plaintiff, joined by Texas Attorney General Ken Paxton (who just last month survived an impeachment trial in the Texas state Senate over alleged corruption and bribery). Their suit accuses three Texas-based Planned Parenthood affiliates of Medicaid fraud over reimbursements for care. Doe doesn’t claim that Planned Parenthood failed to provide care, such as birth control, STI testing, and hormone replacement therapy, in exchange for those reimbursements; across its Texas clinics, Planned Parenthood says that more than 100,000 Texans rely on it for care. Rather, it claims that Planned Parenthood should return the reimbursements, with penalties, because it received them after the state took legal action to exclude Planned Parenthood from Texas Medicaid. However, Planned Parenthood had not yet actually been excluded at the time it received those reimbursements.

The Planned Parenthood Federation of America denies the accusation of fraud, its general counsel Susan Manning calling the case “baseless” after oral arguments in August. What Doe’s lawsuit is really about is “controlling people’s bodies and lives,” as Laura Terrill, CEO of Planned Parenthood of South Texas, told The 19th. “It is not enough here in Texas to simply ban abortion,” she added, “but now the state is shutting down health care providers and preventing them from meeting the health care needs of Texans.” This case is about continuing to paint abortion providers as deserving of punishment. And it started in 2013, as anti-abortion activists plotted a “sting operation” against Planned Parenthood that involved plaintiff Doe.

Ten years ago, a group of anti-abortion activists began planning to “infiltrate conferences attended by Planned Parenthood staff and obtain ‘gotcha’ videos made with hidden recording equipment,” as a federal court case later explained. Their goal, the activists’ own plans stated, was to catch “fetal traffickers, especially Planned Parenthood clinics,” in order to promote “defunding efforts for Planned Parenthood.”

When that group, the so-called Center for Medical Progress, published their “gotcha” videos in 2015, they further fueled Texas state legislators’ ongoing offensive against Planned Parenthood and abortion access. “This latest video showing yet another Planned Parenthood senior official negotiating the price of unborn baby body parts is more than just callous and morally bereft, it may be criminal,” Texas Governor Greg Abbott claimed in 2015.

The state had already turned its back on $30 million in annual federal Medicaid funds because Texas Republicans wanted to exclude Planned Parenthood from the state’s Medicaid Women’s Health Program. With the videos as rationale, in 2015 Abbott went further, launching an investigation into Planned Parenthood, vowing to end its state Medicaid funding. But then a grand jury investigation into Planned Parenthood over the videos resulted in an indictment against members of the Center for Medical Progress; eventually, a federal court awarded Planned Parenthood more than $2 million in damages. Still, after a lengthy court battle, Texas kicked Planned Parenthood off Medicaid in 2021. That was not even the end. The suit in which Alex Doe and Paxton are plaintiffs could bankrupt Planned Parenthood in Texas.

That suit, now before Kacsmaryk and set for trial next year, could force Planned Parenthood to return the Medicaid reimbursements it got while the state’s attempts to deny Medicaid reimbursements to Planned Parenthood were still moving through the courts and before their removal went into effect. But it’s not really about Medicaid, as this decade-long campaign against Planned Parenthood shows.

Doe does not shy away from this; in fact, he claims a leading role. From 2013 to 2015, his suit states, Doe says he “conducted an extensive undercover investigation of Planned Parenthood,” including its “abortion services” and “fetal tissue donation and research program.” He characterizes this as “direct, independent, unique, and personal knowledge obtained during and after the investigation of Planned Parenthood.” Though he has remained anonymous in the suit, in an effort to bolster his own credibility, he essentially admits that he was part of the Center for Medical Progress sting video operation, taking credit in the lawsuit for publishing undercover videos of Planned Parenthood to YouTube himself. This isn’t about fraud, which that same anti-abortion group has engaged in. It’s about vindication.

Consider all that in light of Doe’s lawsuit, which could bankrupt Planned Parenthood, closing clinics in Texas and possibly elsewhere. “I know the state wants to punish Planned Parenthood for being an abortion provider,” said Dr. Amna Dermish, chief medical officer of Planned Parenthood of Greater Texas, “but all you’re doing is punishing patients.” But punishing patients is precisely the goal for Doe and Paxton—and why, no doubt, they’ve brought their case to Kacsmaryk’s court.