{T}he fight over Planned Parenthood has always been over the fact that in most places it simultaneously offers highly popular services — family planning and preventive care — and a far more controversial one — abortion — under the same banner…

And then there were three.

The North Carolina Legislature overrode a veto by Democratic Gov. Bev Perdue Wednesday, approving a state budget that bans public funds from going to Planned Parenthood..

That makes North Carolina the third state in a month to move toward restrictions on government funding of the reproductive services group.

Kansas GOP Gov. Sam Brownback signed a bill barring funding for the organization in his state in May. That move came only a few weeks after the Indiana GOP Gov. Mitch Daniels signed the first Planned Parenthood defunding measure in the nation.

The state laws are not identical. For example, neither the North Carolina nor Kansas measure would directly affect patients on Medicaid. All three, however, would limit funding under the federal family planning program, Title X of the Public Health Service Act.

The federal Department of Health and Human Services has made it abundantly clear that it considers state attempts to bar Medicaid beneficiaries from using Planned Parenthood clinics to receive covered family planning services a violation of federal rules. (The vast majority of abortion services have been banned using federal funds since the 1970s.)

In a letter to Indiana Medicaid Director Patricia Casanova earlier this month, Medicare and Medicaid Administrator Donald Berwick wrote: “[B]eneficiaries may obtain covered services from any qualified provider that undertakes to provide such services.”

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