Kansas' decision to take federal family planning funds away from Planned Parenthood has put the state in a vise.
On one side, the state faces a legal assault from Planned Parenthood, which contends it is being punished because it advocates for abortion rights.
On the other side, the federal government is concerned about ensuring access to family planning services in certain areas of the state.
If Kansas can't satisfy the government's concerns, it will be at risk of losing all or part of nearly $3 million in family planning funds.
On Sunday, the U.S. Department of Health and Human Services wrote to the state, saying it was worried about how Kansas planned to redistribute the money, also known as Title X funds. At issue is a provision in the state budget that in effect took about $330,000 from Planned Parenthood and redirected it primarily to public health departments.
Planned Parenthood already has persuaded a federal judge to block the law temporarily, although the state appealed Tuesday to the 10th Circuit Court of Appeals. The state also separately filed a motion seeking an immediate suspension of the judge's order pending the appeal.
But even as the litigation plays out, the federal government is demanding answers.
Jose Belardo, regional health administrator for Health and Human Services, wants the state to provide evidence that the new agencies could adequately fill the void left by Planned Parenthood, which now sends the federal planning money to Wichita and Hays.
Concern also was expressed about Ford County, where the Dodge City Family Planning Clinic is losing its Title X funds as well. The clinic isn't connected to Planned Parenthood and doesn't offer abortion services, according to published reports.
The federal inquiry potentially could be moot, however, if courts continue to block enforcement of the funding provision.
But if Health and Human Services can document that Kansas — or any recipient of the funds — isn't meeting the terms of its federal grant, then funding could be cut off, officials said.
The Kansas Department of Health and Environment said it isn't worried. The program is being administered according to the requirements set by law, and Health and Human Services so far hasn't indicated otherwise, according to state officials.
They said the letter was a request for information.
Planned Parenthood has used the family planning funds to serve about 5,700 people who make about 8,000 visits a year to clinics in Wichita and Hays.
The money pays for family planning services for low-income women. It also helps pay for cancer screenings.
Planned Parenthood has indicated in court filings that it might have to raise the fees it charges, lay off employees or close its outstate clinics if it loses the money.
The state wants to send about $200,000 more to Sedgwick County to expand family planning services. It also wants to give more money to Ellis County, where Hays is the county seat.
No decision has been made about Ford County, though the state has identified a hospital and another health center as possibilities.
Supporters of defunding Planned Parenthood contend that other providers can offer the same family planning services just as well.