Yesterday’s ruling from the Fifth Circuit Court of Appeals vacated a trial court’s temporary block on a Texas agency’s decision to terminate the state’s Medicaid provider agreement with Planned Parenthood affiliates. The Fifth Circuit reasoned that in an evidentiary hearing over a challenge to the decision, the state agency didn’t get a fair shake, and Planned Parenthood’s evidence improperly received greater weight in a “peculiarly asymmetrical way.”

Undercover videos revealing officials from the Planned Parenthood Gulf Coast (PPGC) illegally engaging in the procurement and sale of fetal tissue and body parts spurred Kansas, Louisiana, and Texas to terminate their Medicaid provider agreements with Planned Parenthood affiliates. Despite states’ “broad authority to ensure that Medicaid healthcare providers are qualified to provide medical services,” none of the states have until now been allowed to cut ties with Planned Parenthood, as ruling after ruling has resulted in success for the challengers.

In Texas, a trial court temporarily blocked the termination effort after affiliates sued. At an evidentiary hearing, the state agency presented evidence to justify its decision, including the videos, which recorded statements from PPGC officials showing that the facility intended to or already had illegally procured fetal tissue and body parts. The research director stated that its doctors had “collect[ed] the specimens . . . in a way that they can get the best specimen,” and the abortion facility director implied that doctors were able to obtain intact fetuses by lying about intent. Forensic analysis showed that none of the videos were “deceptively edited.” Yet the trial court “suggested that [the videos] may have been edited,” and it asserted that the state agency lacked “even a scintilla of evidence, to conclude the bases of termination.”

The Fifth Circuit vacated the trial court’s ruling, concluding that the trial court improperly weighed the evidence without any deference to the state agency’s evidence. In fact, the Fifth Circuit said, the trial court should have done the opposite and upheld the state agency’s decision unless it acted arbitrarily and capriciously.

The Fifth Circuit made clear the trial court’s error by including in the opinion a screenshot from the videos of the remains of a fetus after it was dismembered and discarded in a pool of blood in a glass tray. The image is sad and alarming. But the image boldly displays the crux of the issue. Can it truly be said that a state acts arbitrarily and capriciously by severing ties with an organization saying on camera that it is willing to illegally capitalize on an industry that treats humans with as much dignity as livestock in a meat processing facility?

For the Fifth Circuit, procedure mattered. Because the hearing with Planned Parenthood lacked procedural neutrality, Texas has been allowed another chance to uphold the virtues of health and life and to benefit from the rule of law.