Friday, May 13, 2011

Indiana Becomes the First State to Defund Planned Parenthood, Violating Federal Medicaid Law

On Tuesday, the Indianapolis Star reported that Planned Parenthood of Indiana (PPIN) along with the ACLU of Indiana “…will seek a restraining order to stop the state from cutting off its government funding…”  On Wednesday, Governor Mitch Daniels signed a bill defunding Planned Parenthood; the bill goes into effect immediately.  The legislation also enacts a 20 week abortion ban and “…mandates that doctors tell patients that abortion has been linked to infertility.”  Indiana becomes the fifth state to enact a 20 week abortion ban, joining Nebraska, Kansas, Idaho, and Oklahoma.

Only hours after Governor Daniels signed the law, an ACLU attorney representing PPIN and the solicitor general from the State Attorney General’s office appeared in federal court.  Later on Wednesday, U.S. District Court Judge Tanya Walton Pratt “…denied Planned Parenthood of Indiana's request for a temporary restraining order despite arguments that the law jeopardizes health care for thousands of women on Medicaid.”  The cuts to PPIN can now take effect immediately.  Judge Pratt explained “…the state has not had enough time to respond to Planned Parenthood's complaint and that the group did not show it would suffer irreparable harm without a temporary restraining order.”  The Court has scheduled a hearing for June 6th to rule on PPIN’s request for a permanent injunction “…and Pratt said she will rule on the matter before July 1, when new abortion restrictions included in the law are set to take effect.”  

The joint PPIN and ACLU lawsuit contends that the new abortion restrictions “…forcing doctors to give information -- information they claim is not factual or relevant to the patients and can be misleading…” violates the First Amendment.  USA Today reports that the lawsuit also alleges that because PPIN is being defunded immediately:

…the new law’s defunding provision… would void contracts and grants already in effect, violating the U.S. Constitution's contract clause.  The suit also says that the law imposes an unconstitutional condition on Planned Parenthood by requiring it to choose between performing abortions and receiving non-abortion-related funding, and says that the measure runs afoul of federal Medicaid law.

PPIN president Becky Cockrum said, “[t]he ruling means that Hoosiers who rely on federal funding have lost access to their crucial and lifesaving preventive health care at Planned Parenthood of Indiana."  Specifically, “…Wednesday's ruling means that 9,300 Medicaid patients at Planned Parenthood's 28 locations will lose services from their preferred provider, and her organization must decide soon, perhaps within days, whether it will continue to serve Medicaid patients…[and]… it will have to stop providing intervention services to partners of persons with sexually transmitted diseases in 22 counties.”  PPIN will lose approximately $2 million of the $3 million they receive each year from federal funding. 

Moreover, “…about half of all births in Indiana are funded by Medicaid today and PPIN estimates this will ‘cost the state $68 million in Medicaid expenses for unintended pregnancies by reducing birth control access’.”

Of course, Governor Daniels has told PPIN repeatedly that all they need to do to restore their funding is to stop providing abortion services.  Anti-choice politicians have decided to hold the fundamental constitutional right to choose an abortion hostage while thousands of Indiana’s poorest women pay the ultimate price in this ongoing war on women.  Cockrum’s response to the ultimatum from Governor Daniels, and from every other anti-choice politician in Indiana, was very clear.  She said:

Abortion is a constitutionally protected option for a woman, and some 10,000 or 11,000 women in the state of Indiana avail themselves of that because they determine that's the most right thing for them and for their families…It seems to me it makes sense for us to continue to offer those services.

Last week, in response to the pending enactment of the Indiana law and the fact that defunding Planned Parenthood violates federal Medicaid law, a spokeswoman for the Centers for Medicare and Medicaid Services told the Los Angeles Times:

If the state denies payment to these providers that would be illegal…There are some options available to us.  But I can't say what action will be taken to bring the state into compliance.  All we can say now is we will review the matter once Indiana decides.

Indiana has now defunded Planned Parenthood and a federal judge has refused to issue a temporary injunction to stop the Indiana from becoming the “…first state to cut off public funding to Planned Parenthood for general health services.”  So, theoretically Indiana should now be at risk of losing “…all of its $4 million in federal family planning money…” for violating federal Medicaid law.  And the fact that the federal judge refused to issue a temporary injunction does not bode well for the ultimate success of PPIN’s lawsuit.  If PPIN’s lawsuit fails to restore its funding other states seeking to defund Planned Parenthood will only be emboldened to charge forward. 

This loss of federal family planning funding will not only create a health crisis for vulnerable women in Indiana but also create a fiscal disaster for the Indiana state budget.  More importantly, this fiscal disaster will have been brought on by an allegedly fiscally conservative Republican governor with sincere presidential aspirations.  Apparently, the need to assuage the fears of social conservatives that criticized him earlier this year “…for calling for a truce on social issues,” trumps any genuine need to protect the state’s budget. 

But this question remains unanswered: What will happen to Indiana’s federal family planning budget?  Will the federal government act to protect the most vulnerable women in Indiana?  Will the federal government cut off Indiana’s federal family planning dollars? 

New Hampshire, Kansas, North Carolina, Texas, and Minnesota are also threatening to follow in Indiana’s footsteps and defund Planned Parenthood.  Will the federal government protect the vulnerable women in those states, or will these states be permitted to violate federal Medicaid law with impunity?  To date, not a single spokesperson from the Centers for Medicare and Medicaid Services has answered this question because until this week it was still a hypothetical question.  Indiana’s governor and U.S. District Court Judge Tanya Walton Pratt have now turned that hypothetical question into a political and fiscal reality.  

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