Indiana lawmakers attack reproductive health services

On Tuesday, May 10, Republican Governor Mitch Daniels of Indiana signed HB 1210, which restricts public money going to any agency that provides abortions. Hospitals and ambulatory surgical centers, however, are exempt. Thus, in effect the bill targets Planned Parenthood, a nationwide non-governmental reproductive health care agency that primarily aids the poor and those with limited means. This makes Indiana the first state to pass a bill to stop funding the non-profit, although several states are proposing similar measures.

The bill takes effect immediately since Judge Tanya Walton Pratt has refused to grant Planned Parenthood of Indiana’s (PPIN) request to temporarily block the bill while they pursue a lawsuit against it. PPIN has a Woman’s Health Fund (WHF) that they are using to help their current patients covered by Medicaid, a government-funded health insurance program for certain categories of low-income people. The WHF money is expected to run out on May 30. In response to the situation, PPIN is postponing some services for their current patients, and will not take any new Medicaid patients at this time.

Last year, at the 28 PPIN health centers in the state about 11 percent of patients (approximately 9,300 people) used Medicaid to pay for the services they received. In addition to serving women, about 6 percent of PPIN patients are men. The agency offers its patients reproductive and sexual health exams, Pap smears, screening for cancers, testing for sexually transmitted disease, birth control methods, and abortion counseling and services. It also provides health training and outreach to local communities.

In addition to axing funding for PPIN, HB 1210 also shortens by four weeks—from 24 down to 20—the time allowed for an abortion to be performed. It claims that conception is the beginning of life and requires doctors to take ultrasounds before performing an abortion, warn the woman about fertility problems, and tell her that a fetus can probably feel pain. This part of the bill goes into effect on July 1.

As noted by the American Civil Liberties Union (ACLU), which has joined with Planned Parenthood in the lawsuit against HB 1210, the law requires “doctors to read from a government-mandated script that contains biased, misleading and unscientifically-founded ideas about the beginning of life.”

In her ruling denying PPIN’s request for a restraining order, Judge Pratt said that PPIN had not shown that it would “suffer irreparable harm” if the bill were enacted. She claimed that since PPIN would be able to bill the state for up to a year after it performs services, if the bill is later determined to be unconstitutional and thrown out, PPIN could get paid at that time.

PPIN and other social service agencies insist that the bill is unconstitutional because it violates federal law that says that states cannot discriminate between which medical providers will receive their Medicaid payments since all the providers were already approved by the federal Medicaid program. The lawsuit is scheduled to be heard on June 6 before a US district court, with a decision expected by July 1.

PPIN’s president, Betty Cockrum, said, “It’s very bad for the state of Indiana. It’s a very bad direction for public health policy.” If the bill stands, the state could lose up to $4 million from the federal government for federal family planning grants. Cockrum said that this law would most likely lead to undetected cancers, untreated sexually transmitted diseases, and more unplanned pregnancies.

A recent article in the Christian Science Monitor reported that “the Guttmacher Institute, which works to promote sexual and reproductive health in the US, said recently that ending federal subsidies to Planned Parenthood clinics in Indiana could raise the teen pregnancy rate by 21 percent and the number of abortions by 34 percent, because women wouldn’t have the same access to pregnancy-prevention services.”

With the passage of the bill, Governor Daniels sent out directives to state agencies to refer residents to health agencies other than PPIN. However, there is no indication that other places will be able to fill the hole that this law creates in affordable health care. While his administration insists “that all non-abortion services” will continue to be available, this claim is unfounded.

Even prior to the passage of HB 1210, Indiana was unable to provide adequate health care to all its residents. Per federal criteria, over half of Indiana’s 92 counties do not have adequate health services; in 28 counties, there is a lack of primary care physicians and nurses. Furthermore, many medical professionals do not want to accept Medicaid patients since Medicaid payments are often 40 percent lower than the cost of services.

News reports on the effect of the law on Planned Parenthood’s patients reveal the impossible situation created for the population. Last Tuesday, National Public Radio had an interview with Nicole Robbins, a 31-year-old Planned Parenthood patient who is unemployed and on Medicaid. In search for appropriate medical care, NPR reported, “Robbins went to the Indiana Department of Health looking for information … workers there directed her to a clinic that only does TB testing and standard physicals—no Pap smears, no breast exams, no STD tests.”

Indiana is at the forefront of a nationwide effort by right-wing lawmakers to attack reproductive health service agencies. While those that provide abortions are at the center of this campaign, Elizabeth Nash of the Guttmacher Institute notes that politicians are pushing against all forms of “family planning.”

On May 10, Kansas passed a law that puts Planned Parenthood on the bottom of the list of recipients eligible for Title X funding, a federal grant administered by the states that finances reproductive health services. New Hampshire, Texas and North Carolina legislators are also preparing similar attacks. At the federal level, Republican congressional lawmakers have been working, thus far unsuccessfully, to force through budgetary compromises with their Democratic counterparts that will defund Planned Parenthood.