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If you want to take a generous view of these things, you could say the language of “defunding” Planned Parenthood has always been intentionally imprecise. You could also say it is a well-orchestrated conservative grift intended to bullshit the broader public and fuel the resentments of the Republican Party’s anti-abortion base. Either works.

Here’s an example of this rhetoric from Ted Cruz, an anti-abortion ideologue: “Americans are currently forced to fund millions of dollars each year to the very abortion industry that commits these heinous [abortion] acts. This must end.” And here’s another example from Donald Trump, an idiot: “I would defund [Planned Parenthood] because of the abortion factor, which they say is 3 percent. I don’t know what percentage it is. They say it’s 3 percent. But I would defund it, because I’m pro-life.”

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But there is no federal pot of money set aside to fund Planned Parenthood or abortions, (which, to be clear, would be a good thing to do, even though we do not do that). Instead, the funding mechanism for Planned Parenthood, by and large, is Medicaid reimbursements for services they’ve already provided patients in routine checkups and other visits. So if a person on Mediciad uses Planned Parenthood to get a pap smear, a pregnancy test, or a prescription for a yeast infection, then the government reimburses them for it, like it would any other provider. (Medicaid is prohibited from covering abortion services in almost all cases, in most states.)

Even as Republican lawmakers hammer their misleading statements about funding over and over again, the continued funding of Planned Parenthood, whatever the mechanism, receives overwhelming public support—including from most Republicans. But even if the public did hate it, Medicaid coverage for Planned Parenthood would still provide necessary access to crucial health services for low-income women in this country. It lets people go to the doctor where they choose. Preventative services like cancer screenings save lives. It’s good on all fronts. Which is why a recent court case upholding a state law that blocks women from using Medicaid at Planned Parenthood is so troubling.

Courts have taken up laws trying to block Medicaid reimbursements to Planned Parenthood before, but they’ve always been struck down (even in courts considered otherwise hostile to abortion rights). But as Mother Jones reported on Friday, the 8th Circuit Court of Appeals ruled this week that Arkansas can block Medicaid reimbursements to Planned Parenthood.

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From Mother Jones:

Wednesday’s decision diverged from this long-accepted legal interpretation by calling into question a Medicaid recipient’s right to choose any provider—and subsequently, her ability to defend that right in court. The protections that so many courts have leaned on to protect Medicaid patients’ ability to go to Planned Parenthood are undermined by this ruling, says Elizabeth Sepper, a law school professor at Washington University in St. Louis and an expert on health care and insurance law, and the legal implications extend far beyond Planned Parenthood.

“It’s actually potentially destructive of individual rights [to sue] under the Medicaid Act,” says Sepper. “It potentially drives a giant hole through Medicaid enforcement.”

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It’s possible that the case could find its way to the Supreme Court in the next several years, Sepper went on to say, but the more immediate question is what happens to Medicaid patients in Arkansas if and when this goes into effect. In a statement, Planned Parenthood said it is “evaluating all options” to ensure continued coverage for Medicaid patients, but their fate is unclear. What is clear is the need for comprehensive reproductive health services in the state: According to the data from the Guttmacher Institute, in 2014, 204,850 women in Arkansas were “in need of publicly supported contraceptive services and supplies.”

We have already seen what happens when states, like Texas in 2011, attempt to restrict funding for Planned Parenthood. Patients suffer. Women suffer. The United States already has a system in place that gives poor women and women of color different, lesser access to basic reproductive freedom. This case out of Arkansas, if left unchallenged, is a reminder that we still have lower to go.