Saturday, May 7, 2011

Will Indiana Become the New Planned Parenthood Battleground?

Despite the House of Representative’s failure to defund Planned Parenthood last month, statehouses across the country are now resuscitating the war on Planned Parenthood.  Indiana may become the very first state to defund Planned Parenthood now that Governor Mitch Daniels has offered his unwavering public support for the defunding legislation.  Kansas, North Carolina, New Hampshire, and Texas are also taking up this fight.  In addition to becoming the very first state to defund Planned Parenthood, Indiana may also become the very first Planned Parenthood battleground decided in the courts and confronted by the federal government. 

Last week Indiana’s GOP Governor Mitch Daniels announced that he would sign a bill to defund Planned Parenthood in Indiana; the singular reason being that Planned Parenthood provides abortions.  Politico reports:

The bill bars the state from entering into contracts with abortion providers, making an exception for hospitals and ambulatory centers.  Planned Parenthood of Indiana operates 28 clinics in Indiana, eight of which are Title X funded clinics.  The group received about $3 million in federal funding last year.

Governor Daniels provided a very clear solution for Planned Parenthood’s funding problem.  He stated, "[a]ny organization affected by this provision can resume receiving taxpayer dollars immediately by ceasing or separating its operations that perform abortions."  In response, Cecile Richards, the president of Planned Parenthood Action Fund, said, "[c]learly, Governor Daniels would rather play politics with women’s health than show leadership and fiscal responsibility in rejecting a bill that will ultimately cost the state millions in federal funding.” 

The very public battle Governor Daniels is waging against Planned Parenthood appears more politically motivated than most other GOP governors making similar choices because Daniels will soon announce whether he will be running for the GOP presidential nomination in 2012.  In fact, the New York Times recently explained:

The bill cutting off an expected $2 million in Medicaid financing to Planned Parenthood could have become law without the governor’s signature, and Mr. Daniels’s announcement was viewed by some as a sign that he may be leaning toward running and hoping to increase his appeal among social conservatives.  Some critics of the bill, who lobbied the governor to veto it, said they were surprised he had turned his attention to abortion when he had, of late, focused firmly on matters of the state’s finances and education, including vouchers for private or parochial school tuition.

The Indiana bill not only defunds Planned Parenthood but also enacts a 20 week abortion ban.  If enacted, Indiana would become the fifth state to use the disproved “fetal pain” theory to justify a clear violation of the mandate within Roe v. Wade, joining Nebraska, Kansas, Idaho, and Oklahoma. 

It clearly has become irrelevant to anti-choice politicians that there is no federal funding of abortions and Planned Parenthood’s abortion services comprise only 3% of the overall services they provide to the millions of low-income and vulnerable women throughout the country. 
Planned Parenthood clinics “…across the country perform 1 million screenings for cervical cancer, 830,000 breast exams, and some 4 million tests and treatments for sexually transmitted diseases.”  However, for anti-choice politicians the very fact that Planned Parenthood offers any abortion services should automatically disqualify them from federal funding.  Kansas Representative John Rubin (R) explained, "[i]f that money goes to Planned Parenthood to use for other purposes, that frees up Planned Parenthood to fund abortions, that's the problem we have with it…"

Trying to reason with such specious arguments has become an exercise in futility for Planned Parenthood advocates across the country. 

The hypocrisy of the anti-choice argument to defund Planned Parenthood in Indiana becomes even clearer when “…many of the clinics being effected [sic] don’t even perform the procedure.”  In fact, Indiana’s Journal Gazette explains, “[i]n northeast Indiana, Planned Parenthood served more than 5,300 patients last year – and performed zero abortions…Planned Parenthood has clinics in Elkhart and Fort Wayne, both of which see patients from surrounding counties as well.  Neither provides abortion services.” 

Anti-choice politicians unabashedly lie about Planned Parenthood services while simultaneously promoting Planned Parenthood as a federally funded abortion mill.  This demonization of Planned Parenthood not only represents an attack on access to critical health care and basic contraceptive services for millions of women, but this calculated demonization is clearly intended to further constrain abortion access across the country as well.  

Fox News points out that the defining political difference between the Planned Parenthood battles in the statehouses from the House GOP leadership’s war on Planned Parenthood is:

…unlike Washington, where Democrats still control two thirds of government, Republicans are flexing their muscles in states where they made historic gains in legislatures and governors' mansions in last fall's midterm elections.  With their new power, Republicans have escalated their fight against abortion and its providers -- particularly Planned Parenthood -- alarming abortion-rights supporters.

The battleground parameters in Indiana will be defined by how far Planned Parenthood of Indiana can take their fight against Governor Daniels.  Theoretically, Governor Daniels is risking the loss of $4 million in federal Medicaid funds because according to a “…spokeswoman for the Centers for Medicare and Medicaid Services (CMS)…states that try to restrict Medicaid beneficiaries freedom of choice for family planning services ‘risk losing federal support…States cannot restrict Medicaid beneficiaries freedom of choice of family planning services even if the state is running a managed care program’…” 

And despite being known as a fiscal conservative, Daniels still has not addressed this potential loss in federal funding.  Defunding Planned Parenthood in Indiana “…would leave 22,000 poor residents of Indiana, who use Planned Parenthood’s 28 health facilities in the state, with nowhere to go for a range of women’s services, from breast cancer screening to birth control.” 

Planned Parenthood of Indiana President and CEO Betty Cockrum said “…Daniels' decision to sign the bill was unconscionable and unspeakable.  ‘We will now suffer the consequences of lawmakers who have no regard for fact-based decision making and sound public health policy’…"

Planned Parenthood of Indiana (PPIN) plans to challenge the law in court.  On Tuesday, I asked Betty Cockrum what PPIN will do if the law is enacted and whether they expect any support from the federal government in challenging the law.  Cockrum sent me the following statement in response:

Indiana will immediately file for injunctive relief once House Bill 1210 is signed into law by the Governor.  While it is likely that the executive branch at the Federal level is monitoring this activity here in Indiana, it may well be that they will wait until final action has actually occurred before they weigh in.  In the meantime, as I said, PPIN will be headed to court to delay and minimize the impact of the bill.  You may rest assured that PPIN and its partners across the state and nation are fully engaged in protecting our patients in every way and at every juncture.

And in an effort to forestall this kind of litigation from Planned Parenthood, this week Texas legislators “…inserted a poison bill into a women's health program… a provision that would shut it down immediately if a group that provides abortions files and wins a lawsuit to participate in the program.”  Texas state Senator Bob Deuell (R) explained, "[t]he legislature has clearly tried to cut off funding for these entities, only to have it restored by lawsuit…We do not want this to happen again ... if abortion providers are able to sue and win — they have to win the suit — the program will cease to operate." 

Planned Parenthood declared that the proposed Texas legislation would not deter a court challenge to the law.  The president and CEO of Planned Parenthood Gulf Coast declared:

[b]y banning Planned Parenthood from providing health care to more than 40,000 Texas women through the Medicaid Women's Health Program, this Senate bill shreds the health care safety net that saves lives and dollars…Planned Parenthood is prepared to move forward with a lawsuit if that's what it takes to continue to provide cervical cancer screenings and other health care to the women who depend on our health centers.

Beyond PPIN’s court challenge, the question remains will the federal government confront the discriminatory policy of singling out Planned Parenthood for Medicaid defunding?

The Huffington Post reported last week that while the Centers for Medicare and Medicaid Services “…confirmed… that states ‘cannot pick and choose who gets family planning funds’…[they]…would not comment on whether Indiana would face sanctions for violating this rule.” 

Tellingly, the federal government’s failure to respond to South Dakota’s ongoing and unchallenged violation of federal Medicaid law may be instructive on this point.  According to the Guttmacher Institute, the Hyde Amendment, while only permitting the use of federal funds for abortion:

…in cases of life endangerment, rape or incest, has guided public funding for abortions under the joint federal-state Medicaid programs for low-income women.  At a minimum, states must cover those abortions that meet the federal exceptions.  Although most states meet the requirements, one state is in violation of federal Medicaid law, because it pays for abortions only in cases of life endangerment.

South Dakota has been permitted to violate federal Medicaid law, without sanction from the federal government, ever since the Clinton administration established in 1993 that under the Hyde Amendment Medicaid funds must cover abortions not only in cases of life endangerment but also in cases of rape and incest. 

If Indiana defunds Planned Parenthood and a domino effect begins in many other states around the country, will the federal government challenge this clear violation of federal Medicaid law? 

Another possible avenue for women’s rights groups to fight back against the onslaught of state Planned Parenthood defunding efforts would be to file a complaint with the Centers for Medicare and Medicaid Services. 

In January, the National Women’s Law Center issued two reports revealing “…that certain religiously affiliated hospitals put women’s health and lives at risk by restricting doctors’ ability to provide the best medical care to pregnant women experiencing miscarriages and ectopic pregnancies.”  Consequently, the National Women’s Law Center filed a complaint with the U.S. Department of Health and Human Services urging them to remind all health care providers that they must abide by all Medicare Conditions of Participation (CoPs), and “…require hospitals to institute policies and procedures to protect patients’ legally enforceable rights; to investigate the failure of hospitals to provide standard of care and informed consent, and to take corrective action to prevent further violations.”

And in July 2010 the American Civil Liberties Union (ACLU) also filed a similar complaint with the Centers for Medicare and Medicaid Services (CMS) regarding the denial of health care at certain religiously affiliated hospitals.  The ACLU’s complaint to CMS delineated and addressed “…potential violations of the Emergency Medical Treatment and Active Labor Act (EMTALA)…and the Conditions of Participation of Medicare and Medicaid (COP)…by religious hospitals that refuse to provide emergency reproductive health care.”  The ACLU requested that CMS investigate the issue and “…clarify in the appropriate CMS program manual, and issue a transmittal, that denying emergency reproductive health care violates federal law.”

With the aggressive anti-choice agenda to defund Planned Parenthood across more and more states around the country, a concerted plan to attack this insidious effort to deprive vulnerable women of critical health care services is needed immediately.  The war against Planned Parenthood calls for an urgent all hands on deck strategy. 

In the meantime, Planned Parenthood of Indiana welcomes your support.  Please consider a Pledge-A-Protest donation to protest Governor Daniels’s politically motivated decision to deprive Indiana’s most vulnerable women of critical health care services. 

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