May 11, 2011 — Gov. Mitch Daniels (R) on Tuesday signed a bill (HB 1201) into law that cuts off most state-controlled federal funding to clinics affiliated with Planned Parenthood of Indiana and bans abortion in the state after 20 weeks, prompting the organization and the American Civil Liberties Union of Indiana to immediately request an injunction and temporary restraining order to stop the measure from taking effect, the Los Angeles Times reports (Levey, Los Angeles Times, 5/11).
The bill prohibits state contracts or grants to any entity that provides abortion services. However, it exempts hospitals and other surgical centers so it effectively singles out Planned Parenthood clinics in Indiana for the funding restrictions. This means that the bill would block state funds and federal money that flows through the state from going to Planned Parenthood clinics; in effect, the bill would bar Medicaid beneficiaries from obtaining care at Planned Parenthood clinics in Indiana. Although federal law already prohibits the use of federal Medicaid funds to pay for abortion care, Planned Parenthood clinics can receive reimbursement from Medicaid for all the non-abortion health care services their clinics provide. Patient fees and private funds pay for abortion care provided at Planned Parenthood clinics.
In addition, the bill would ban abortion after 20 weeks of pregnancy unless a woman's life or health is substantially threatened. Current state law permits abortion before viability, which was generally determined by doctors to be several weeks beyond the 20 week threshold provided for in the bill. The legislation would require abortion providers to inform women in writing that human life begins when the egg is fertilized, that abortion can increase the chances of infertility and that a fetus might feel pain before 20 weeks (Women's Health Policy Report, 5/4).
Decision Expected Today
PPIN and ACLU of Indiana filed their request before U.S. District Judge Tanya Walton Pratt, asking her to consider striking down the law on constitutional grounds, the Indianapolis Star reports. The groups have asked that Pratt allow federal funding to PPIN to continue while she considers whether to strike down the law.
Pratt said she would announce her decision by noon on Wednesday, according to Kenneth Falk, legal director of the ACLU of Indiana. According to the Star, Pratt must consider whether PPIN is likely to prevail, which side would be harmed the most if the law is allowed to take effect and what action is in the public's interest.
PPIN and ACLU of Indiana argue that the measure forces doctors to provide patients with information that is not factual or relevant, which would be misleading and violate the First Amendment's free speech protections, according to the Star. The lawsuit also contends that the law's defunding provision would void contracts and grants already in effect, a violation of the Constitution's contract clause. The groups said the law imposes an unconstitutional condition on Planned Parenthood by requiring it to choose between providing abortion services and receiving non-abortion-related funding, in addition to possibly violating federal Medicaid law. PPIN President Betty Cockrum said, "Hopefully by (this) afternoon, we have the kind of resolution that we're seeking, which is that none of our patients have to be told that they cannot have their Pap tests and get their birth control at our locations across the state."
Joel Schumm, a professor at the Indiana University School of Law, said the suit's claims are strong. "If you're balancing harms (to each side), a woman's interest in reproductive freedoms is a significant constitutional right, as opposed to the state's argument, which is how to spend money," he said. The provision telling physicians what to say "is a new requirement that didn't exist before," he said. Therefore, putting it on hold while its legality is determined would not harm the state, according to the Star (Gillers/Murray, Indianapolis Star, 5/11).
Effects of the Law on Patients
According to Cockrum, the bill would have the most serious effects on Medicaid beneficiaries and uninsured people whose incomes are too high to qualify for Medicaid. "If you look at the 9,300 Medicaid patients we served, some of them will become medically vulnerable," Cockrum said.
Daniels has said his administration reviewed women's access to sexual and reproductive services "and can confirm that all non-abortion services, whether family planning or basic women's health, will remain readily available in every one of our 92 counties." Cockrum disputed that claim and said that antiabortion-rights crisis pregnancy centers, which do not offer clinical care, were included in the count.
Eric Coulter, director of the Wayne County Health Department, said community health centers would have trouble handling a rush of new patients. "We'd have to add additional help or they'd experience long delays in getting in, which defeats the purpose," Coulter said. Community health centers have faced budget cuts the last two years, and officials are waiting to see how much funding they will receive in the new state budget for the next two years (Tharp, Richmond Palladium-Item, 5/9).