PHOENIX -- Arizona has lost another battle in its ongoing war to restrict abortions, adding to a growing list of defeats this year for the state's anti-abortion movement.
On Thursday, the 9th U.S. Circuit Court of Appeals ruled that Arizona cannot strip Medicaid funding from doctors and clinics that perform abortions, upholding a lower-court ruling.
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House Bill 2800, which the Legislature passed and Gov. Jan Brewer signed in 2012, would have halted Medicaid reimbursements for contraceptives, cancer screenings, treatment for sexually transmitted diseases and annual women's exams at the state's more than 80 hospitals and clinics that also perform abortions.
It is already a violation of state law to spend state or federal money on elective abortions, and that prohibition was not disputed in this case.
"It's disappointing that Arizonans are going to continue to have to subsidize the abortion industry and Planned Parenthood," said Center for Arizona Policy spokesman Aaron Baer, whose organization wrote the law. "Arizona is a pro-life state. This was a measure that the people of Arizona wanted. We shouldn't be forced to give taxpayer money to any organization that performs abortions."
The opinion comes on the heels of a May ruling from the same court overturning a 2012 state law banning abortions after 20 gestational weeks of pregnancy. It also follows the first legislative session in more than a decade in which lawmakers failed to pass an abortion-related law.
Anti-abortion leaders, who were regrouping after Thursday's ruling, are essentially left with two options: appeal to a U.S. Supreme Court that is often more conservative in its decisions than the 9th Circuit, or try their luck with a 2014 Legislature that may be more willing to push abortion issues in an election year.
The appeals court in its opinion said the defunding law violates the federal Medicaid Act because it limits patients' options when choosing a doctor.
"The free-choice-of-provider provision unambiguously requires that states participating in the Medicaid program allow covered patients to choose among the family-planning medical practitioners they could use were they paying out of their own pockets," the opinion states.
The court dismissed the state's argument that Arizona has the power to determine which doctors are qualified to serve Medicaid patients, saying that would open the door to a free-for-all in which states could ban doctors for arbitrary reasons such as their smoking habits or where they obtained their medical degrees.
"This is a victory for the thousands of low-income women who rely on Planned Parenthood for breast and cervical- cancer screenings, birth control and other basic health care," Planned Parenthood Arizona President and CEO Bryan Howard said in a statement.
Arizona Attorney General Tom Horne and the Christian legal group Alliance Defending Freedom argued the state's case.
Alliance senior counsel Steven Aden said they are "evaluating appropriate next steps."
If they appeal to the Supreme Court, there's no guarantee the high court will agree to hear the case. The court historically has been most interested in cases in which multiple appellate courts have issued conflicting opinions. On this issue, the lower courts have mostly been in agreement.
Arizona's statute is most similar to an Indiana law, which the 7th U.S. Circuit Court of Appeals overseeing Indiana overturned earlier this year. The U.S. Supreme Court declined to hear an appeal of that ruling.
The high court is also still an option in the law banning abortions after 20 weeks. Supreme Court Justice Anthony Kennedy has given Maricopa County Attorney Bill Montgomery until Sept. 28 to decide whether to appeal.
The Center for Arizona Policy could also try to revive the laws by introducing bills containing a slightly different version of the measures when the legislative session begins in January.
The organization does not disclose in advance the bills it will introduce, but it could again propose a bill that failed to gain traction this year.
The group sought a more limited version of HB 2800 that would forbid clinics from providing abortion services and Medicaid services to the same person.
The bill got lost amid political negotiations as more moderate Republicans and Democrats united to push for Medicaid expansion. It never got a final vote.
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