September 19, The President The White House 1600 Pennsylvania Avenue NW Washington, DC Dear Mr. President:

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September 19, 2017 The President The White House 1600 Pennsylvania Avenue NW Washington, DC 20500 Dear Mr. President: We thank you for your attention to advancing pro-life issues since taking office, including giving our states the freedom to direct the spending of our Title X family planning dollars to entities that match our states needs and values. Today, we are writing to urge you to give our states similar flexibility in our Medicaid programs. Medicaid is the largest taxpayer funding stream for the nation s largest abortion provider, Planned Parenthood. In fact, according to research by the Charlotte Lozier Institute, Planned Parenthood commands 35% of the abortion market. In the wake of yet another state (South Carolina) seeking the same flexibility with Medicaid dollars, combined with the recent ruling in the 8 th Circuit US Court of Appeals approving Arkansas decision not to fund abortion providers in their Medicaid program, it is essential that your administration respond quickly. It is time to remove the administrative barrier to our states right to direct dollars away from abortion providers: Medicaid guidance issued by the Obama administration. 1 We are a coalition of almost two hundred pro-life women lawmakers in forty-three states and at the federal level. We are devoted to measures that enhance the well-being of women and show respect for the intrinsic value of every human life in our states. We have invited other lawmakers to join us on this letter; our male and female colleagues in state legislatures with whom we have gone as far as we can to defund abortion providers with the tools we have. Now we seek your help to unlock this massive barrier to state discretion. We write to ask you to direct the Department of Health and Human Services, Centers for Medicare and Medicaid Services to rescind the interpretation that states must reimburse abortion providers and, 1 https://www.medicaid.gov/federal-policy-guidance/downloads/smd16005.pdf

instead, issue guidance giving us the flexibility to set reasonable standards that are in the best interests of our respective Medicaid programs and the patients they serve. The prior administration s attempt to force our states to fund the abortion industry must be reversed, and we must be allowed to spend these millions of dollars in a manner that is consistent with standards that are in the best interest of women s health and safety. Thank you for your consideration. Sincerely, Representative Terri Collins Alabama Senator Nancy Barto Senator Sylvia Allen Senator Gail Griffin Senator John Kavanagh Senator Steve Smith Senator Debbie Lesko Senator Steven B. Yarbrough Senator Kimberly Yee Senator Warren Petersen Representative Jill Norgaard Representative David Livingston Representative Vince Leach Representative Drew John Representative Kevin Payne Representative Paul Mosley Representative David Cook Representative Paul Boyer Representative Ben Toma Representative Darin Mitchell

Representative John Allen Representative Kelly Townsend Representative Jay Lawrence Representative Don Shooter Representative Travis Grantham Representative Mark Finchem Assemblyman Jim Patterson California Representative Kim Ransom Colorado Representative Lori Saine Colorado Representative Scott Hilton Georgia Representative Brad Raffensperger Georgia Representative Bob McDermott Hawaii Representative Tom Morrison Illinois Representative Ron Bacon Senator Liz Brown Senator Travis Holdman Senator Erin Houchin Senator Dennis Kruse Representative Sandy Salmon Iowa Senator Mary Pilcher-Cook Kansas Representative Susan Humphries Kansas Delegate Susan Krebs Maryland Senator Judy Emmons Michigan Senator Michelle Benson Representative Cindy Pugh Representative Abigail Whelan Representative Jim Knoblach Senator Robert F. Onder, M.D., J.D. Missouri

Representative Donna Lichtenegger Missouri Representative Jeanine Notter New Hampshire Senator Joyce Krawiec Senator Shirley B. Randleman Senator Dan Bishop Senator Ralph Hise Senator Norman Sanderson Senator Tommy Tucker Senator David Curtis Senator Deanna Ballard Senator Kathy Harrington Representative Pat McElraft Representative John Bradford III Representative Jeffrey Elmore Representative Larry G. Pittman Representative Michael Speciale Representative Carl Ford Representative Beverly G. Boswell Representative Cody Henson Representative Kelly Hastings Representative Debra Conrad Representative George G. Cleveland Representative Phil Shepard Representative Michele Presnell Representative John Torbett Representative Rena Turner Representative Jay Adams Representative John Sauls

Representative Mark Brody Representative Mike Clampitt Representative Dennis Riddell Representative Allen McNeill Representative Frank Iler Representative Susan Martin Representative Linda Hunt Williams Representative Destin Hall Representative Jason Saine Representative Jonathan C. Jordan Representative Pat Hurley Representative David Rogers Representative Jimmy Dixon Representative Dean Arp Representative Julia Howard Representative Mitchell Setzer Representative Brenden Jones Representative Larry Yarborough Representative D. Craig Horn Representative Bob Steinburg Representative Donna White Representative Scott D. Stone Representative Chris Millis Representative Bert Jones Representative Dana Bumgardner Representative Kyle Hall Representative Donny Lambeth Representative Holly Grange

Representative Larry Potts Senator Janne Myrdal North Dakota Senator Karen Rohr North Dakota Representative Christina Hagan Ohio Senator Julie Daniels Oklahoma Representative Kathy Rapp Pennsylvania Representative Heather Ammons Crawford South Carolina Representative Debra Moody Tennessee Senator Janice Bowling Tennessee Representative Stephanie Klick Texas Representative Cindy Burkett Texas Senator Margaret Dayton Utah Senator Amanda Chase Senator Charles W. Carrico Senator Glen Sturtevant Delegate Nick Freitas Delegate R. Steven Landes Delegate Tony Wilt Delegate Dave LaRock Delegate John O Bannon Delegate Brenda Pogge Delegate Ben Cline Delegate Riley Ingram Senator Jan Angel Washington Senator Mike Padden Washington Senator Mark Miloscia Washington Delegate Kelli Sobonya West Delegate Kayla Kessinger West