May 12, 2011 — U.S. District Judge Tanya Walton Pratt on Wednesday denied Planned Parenthood of Indiana's request for a temporary injunction against a newly signed law that bars most state-controlled federal funding to clinics affiliated with Planned Parenthood of Indiana and bans abortion in the state after 20 weeks, the AP/Sacramento Bee reports (AP/Sacramento Bee, 5/11).
On Tuesday, Gov. Mitch Daniels (R) signed the bill (HB 1201) into law to prohibit state contracts or grants to any entity that provides abortion services, prompting PPIN and the American Civil Liberties Union of Indiana to file suit against the measure. The measure exempts hospitals and other surgical centers, effectively singling 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, 5/11).
Details of Decision
In filing suit against the law on behalf of PPIN, ACLU attorneys had also requested an immediate injunction to prevent the law from taking effect pending a decision on the lawsuit. Pratt's decision yesterday was on the injunction request, and her denial of the request allows the funding restriction provisions in the law to take effect immediately. The provision of the law banning abortion after 20 weeks becomes effective July 1, 2011 (AP/Sacramento Bee, 5/11). The court on June 6 will hold a hearing on the underlying lawsuit, the Evansville Courier Press reports. In regard to her decision about denying the immediate injunction Pratt said, "This court is not persuaded" that the law "will have a concrete and immediate effect," adding that she denied the request for an emergency hold partly because the funding losses will come slowly rather than as an immediate hit. She noted that the ruling is "narrowly confined" to the request for a temporary injunction and that the decision does not predict the outcome of next month's hearing.
Meanwhile, Planned Parenthood is deciding how it can pay for treatment of its 9,300 patients it is currently serving. "There's certainly a chance that we will have to decide that we cannot see Medicaid patients unless they are able to somehow pay for their services themselves," PPIN President Betty Cockrum said (Bradner, Evansville Courier Press, 5/11).
Planned Parenthood has become a top target for social conservatives in statehouses and in Congress, the Christian Science Monitor reports. Other states might look to Indiana's law as a model, potentially reshaping the way reproductive health is provided in much of the country, according to the Monitor.
Such laws could ultimately affect availability of women's health care, Beth Burkstrand-Reid, a professor at the University of Nebraska College of Law, said. "The judgment about how laws impact availability is extremely complex and to ... say, 'There's another provider out there,' may be to obscure all of the intangibles that go into accessing reproductive health services," she said. She added, "A suitable alternative is in the eyes of the beholder, and what's happening around the country is we have politicians and judges making determinations about what is a suitable level of available health services."
Supporters of the Indiana law argue that there are many other reproductive health care providers. However, according to the Guttmacher Institute, ending the funding to Planned Parenthood clinics in Indiana could raise the teen pregnancy rate by 21% and the number of abortions by 24% because women would have less access to pregnancy prevention services (Jonsson, Christian Science Monitor, 5/11).
Cockrum said, "It's going to be a rare and fortunate circumstance for the disenfranchised Medicaid patient if in fact they can find a health care center that is close. Do they have the same customer-friendly hours? Do they provide the entire array of services that we do at the same very competitive rates?" (Evansville Courier Press, 5/11).
Indiana's law raises other legal questions, particularly whether it conflicts with federal Medicaid regulations that prohibit states from picking which organizations receive Medicaid funding. ACLU argues that the law violates women's rights by curbing the rights to choose providers (Christian Science Monitor, 5/11).