Eight days after the Supreme Court upheld the constitutionality of the Affordable Care Act’s individual mandate and ruled that the federal government cannot penalize states that refuse to expand Medicaid, Texas Gov. Rick Perry (R) announced that he would not open the program to more applicants. But while he was making a public show of turning down federal funds, Perry was using the additional dollars in state budget projections.

In a letter explaining how he would fill a budget gap left by Texas’ decision to defund Planned Parenthood, Perry’s office uses the money the federal government will pay states that make Medicaid available to individuals up to 133 percent of the Federal Poverty Line in its budgetary assumptions:

Greta Rymal, Deputy Executive Commissioner for Financial Services, has projected the fiscal impact of this rule for three years, assuming that all clients will be eligible for Medicaid following the expansion of the Medicaid program in January 2014 [...]

Several months ago, the Texas health commissioner signed a rule to ban Planned Parenthood or any organization the state considers an “abortion affiliate” from participating in Medicaid’s Women’s Health Program, which “provides low-income women with family planning exams, related health screenings and birth control” throughout Texas. The state’s discrimination against a specific health provider violated federal rules and led Washington, which had financed 90 percent of the WHP through Medicaid funds, to block Texas from receiving further funding for the program.

According to a new report from the George Washington University School of Public Health, more than 52,000 people benefited from Planned Parenthood’s services as part of the Women’s Health Program in Texas in 2010.

Arijit Guha, a 31-year-old doctoral student at Arizona State University, hit his lifetime limit of $300,000 on his student insurance plan very quickly while fighting Stage 4 colon cancer. To pay for the remaining $118,000 in medical bills from his chemotherapy treatments, Guha started selling items on his website, Poop Strong, in February. He said a friend called his fundraiser “the world’s most important bake sale,” and he told Wonkblog’s Sarah Kliff that it “feels like this weird joke, that I’m selling T-shirts to pay for chemotherapy.”

In late July, Guha tried a faster way to address the unpaid bills: Twitter. He used the social media site to call out his insurance carrier, Aetna:

He sent a tweet to his insurance carrier, Aetna: “@Aetna’s 4th qtr profit up 73%: ‘it continued to benefit from low use of health care.’ Helps they can ensure low use.”

After he engaged in a back-and-forth with chief executive Mark Bertolini, the insurance company moved quickly to work out a solution. Within 24 hours, Guha’s 23-word tweet had done more than six straight months of fundraising ever could: It persuaded Aetna to cover all his outstanding medical bills, showcasing the power of social media to catalyze swift action from a major company. [...]

“Although he reached the limits of his plan, Aetna care managers have continued to provide support and we have worked to develop a solution,” the company said in a statement. [...]

Guha has come away with a similar conclusion. He was ecstatic about the result. But he also considers himself as an exception to the rule: Not every American struggling with medical debt gets into a Twitter exchange with a health insurance CEO and catches a lucky break.

Thanks to Obamacare, insurance providers will have to eliminate lifetime limits on health care plans. This regulation kicked in for student insurance plans in July 2012, so Guha will not have to worry about the $300,000 limit he passed long ago the next time he renews his insurance plan. And students who sign up for insurance plans through their universities will be guaranteed more comprehensive coverage.

As ThinkProgress reported in June, the plans some schools offer are mini-med plans that provide almost no protection when students actually get sick or injured. Upping the standards will lead to much better coverage for more students, and it is possible to avoid rising costs while improving benefits. In Massachusetts, for example, a number of schools joined together to buy coverage collectively for 12,000 students without dramatically increasing premiums.

According to the Government Accountability Office, 600,000 students — 7 percent of 18 to 23-year-olds in college — bought insurance through their school’s plans. By providing more comprehensive plans, like removing lifetime limits, future students faced with the same situation as Guha hopefully will not have to turn to T-shirt sales and Twitter to cover their cancer treatments.

According to one North Carolina Republican, Planned Parenthood’s health clinics — which provide critical health services for thousands of women at their nine locations throughout the state — are doing nothing more than “getting wealthy on murder for hire.”

State Rep. Larry Pittman (R) had a strong reaction to a recent email from Planned Parenthood that appealed state legislators not to cut funding to the organization. Pittman responded to the email, which was sent to each member of the NC House of Representatives Health and Human Services Appropriations committee at the end of May, with allegations that Planned Parenthood is a “murderous organization”:

PITTMAN: [Planned Parenthood] is a murderous organization…getting wealthy on murder for hire. It deals out nothing but deception, death, personal devastation, and moral degradation. Never will I agree to give that bloody, indecent, immoral organization one penny. I will not be satisfied until it is outlawed.

North Carolina’s Planned Parenthood clinics are facing budget cuts that will essentially serve to defund the organization, a tactic that Republicans across the country are using to attack Planned Parenthood. The Republican-controlled legislature passed a budget in July that strips state funding for the organization and its affiliates.

Some North Carolina residents are criticizing Rep. Pittman’s harsh email response, pointing our that “regardless of anyone’s stance on abortion, the point of this story is how unprofessional and inappropriate our elected government official has acted.” When the Independent Tribune asked Pittman to comment on this criticism, he simply doubled down on his overblown rhetoric:

PITTMAN: My sources tell me that 75 percent of [Planned Parenthood’s] income comes through abortions. To say that they would try to reduce the incidence of abortion is like saying a baker would go around trying to get people to stop eating bread.

Pittman’s sources are wrong. Nationwide, abortion services contribute to just three percent of Planned Parenthood’s total health services. In North Carolina alone, Planned Parenthood’s health clinics provide over 18,000 tests for sexually transmitted infections, over 11,000 breast and cervical cancer screenings, and contraceptive services to more than 61,000 women.

This is not the first instance that Pittman, who is running unopposed for reelection in his district, has circulated his radical anti-choice views over email. In January, he sent an email to every member of North Carolina’s General Assembly to say he favors bringing back public hangings for abortion providers.