June 3, 2011 — Indiana officials on Thursday said they will continue enforcing a new state law that bans the state from providing grants or contracting with organizations that provide abortion services, National Journal Member reports. To implement the new law, Indiana needed to amend its state Medicaid plan -- an action that requires federal approval. The officials' comments were in response to a letter from CMS Administrator Donald Berwick saying that CMS would not approve the changes to Indiana's Medicaid plan because they do not comply with federal Medicaid regulations (Fox et al., National Journal, 6/2).
The Indiana law effectively prohibits Medicaid reimbursements for services provided in clinics affiliated with Planned Parenthood of Indiana. For years, federal law has prohibited the use of federal Medicaid funds to pay for abortion services. Prior to enactment of the law, PPIN could receive reimbursement from Medicaid for the non-abortion-related services it provides. The state began enforcing the law on May 10.
In Wednesday's letter to Patricia Cassanova, director of Indiana's Office of Medicaid Policy and Planning, Berwick wrote, "Medicaid programs may not exclude qualified health care providers from providing services that are funded under the program because of a provider's scope of practice." He continued, "Such a restriction would have a particular effect on beneficiaries' ability to access family planning providers." The Indiana law "would eliminate the ability of Medicaid beneficiaries to receive services from specific providers for reasons not related to their qualifications to provide such services," the letter said. Berwick added, "We assume this decision is not unexpected" (Women's Health Policy Report, 6/2).
In an interview on Thursday, Berwick said, "We fully expect Indiana to comply with the [federal] law." However, Marcus Barlow, spokesperson for the Indiana Family and Social Services Administration, said, "We were just advised by our lawyers that we should continue to enforce the Indiana law."
Berwick also cited a notice sent on Wednesday by Cindy Mann -- director of the CMS Center for Medicaid, CHIP and Survey & Certification -- reminding states that they may not restrict providers from the Medicaid program. Berwick implied that Indiana and other states considering similar measures could risk losing all federal Medicaid funding by defying the federal rules.
Planned Parenthood of Indiana has sued over the Indiana law. A hearing is scheduled for Monday in U.S. District Court, with a ruling expected by July 1 (National Journal, 6/2).
New York Times Editorial Praises Obama Administration for Rejecting Ind. Measure
The Obama administration "rightly decided to reject a mean-spirited and dangerous Indiana law," the New York Times writes in an editorial. The law "would punish thousands of low-income women on Medicaid, who stand to lose access to affordable contraception, life-saving breast and cervical cancer screenings, and testing and treatment for HIV and other sexually transmitted diseases," the editorial states. The funding ban would make it "harder for women to obtain birth control," which is "certainly a poor strategy for reducing the number of abortions," the Times continues.
Planned Parenthood "is a favorite target [of antiabortion-rights lawmakers] because a small percentage of its work involves providing abortion care even though no government money is used for that purpose," the editorial notes, adding that North Carolina, Texas, Wisconsin and Tennessee also are considering measures to block funding through Medicaid or the Title X family planning program. "Many of these fresh attacks on reproductive rights, not surprisingly, have come in states where the midterm election left Republicans in charge of both chambers of the legislature and the governor's mansion," the Times concludes (New York Times, 6/2).