A federal judge on Wednesday refused to stop the implementation of Indiana's first-in-the-nation law to cut funding to Planned Parenthood, hinting at the potential difficulties ahead for the organization as it challenges the law in court.
As the nation's leading provider of abortions, Planned Parenthood has become a top target for conservatives in statehouses and in Congress. The Republican-controlled US House unsuccessfully sought to zero funding for the organization, and other states are considering Indiana-like laws.
For advocates of Planned Parenthood, the prospect of other states following suit is disastrous. They argue that Indiana's decision to deny Planned Parenthood $1.4 million in Medicaid money could leave thousands of women, particularly low-income residents, without access to vital health-care services.
That argument, however, appears to have had little success in court. In the past, for example, courts have upheld state laws that have had the effect of increasing driving distances to abortion clinics. On Wednesday, federal District Court Judge Tonya Walton Pratt refused to issue an injunction against the Indiana law, saying Planned Parenthood couldn't support its claim that it would suffer irreparable harm if the law took effect immediately.
With other Republican-held legislatures poised to follow Indiana's lead, the case points to the potential for a recasting of women's health services in several states nationwide.
Would the law limit access?
The aggregate result could ultimately affect the ability of some American women to get the care they want, says Beth Burkstrand-Reid, a professor at the University of Nebraska College of Law in Lincoln.
"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," says Professor Burkstrand-Reid. "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."
For his part, Indiana Gov. Mitch Daniels (R) cites a survey that concluded that women in all 92 of the state's counties will continue to have "readily available" access to reproductive-health services, even if the state stops Medicaid funding to Planned Parenthood. "We will take any actions necessary to ensure that vital medical care is, if anything, more widely available than before," Governor Daniels said.
According to Jane Jankowski, Daniels's press secretary, state health and human service agencies reported that there are women's health centers that don't provide abortions in proximity to all of Planned Parenthood's 28 Indiana locations. "This [law] isn't going to affect anybody's health care," she says.
What the law does
The Indiana law makes it illegal for the organization to take federal Medicaid money, which is disbursed by the states. As part of a growing legislative trend, the law also sets stricter conditions on abortion: banning it past 20 weeks of pregnancy and ordering doctors to inform patients that having an abortion could affect their fertility.
The new law, supporters say, is intended to allow women on Medicaid to redirect their payments to other providers. “The goal would be to take money removed from the Planned Parenthood organization and redistribute that money into other clinics,” Donna Golob, director of A Positive Approach to Teen Health, a northwest Indiana nonprofit, told the Post-Tribune newspaper in Gary, Ind. "They’re not taking away services. They’re changing who is providing them and overall providing women more of a total health package rather than a crisis health package.”
Abortion-rights advocates suggest that the situation is not that cut and dried. The Planned Parenthood clinics are clearly fulfilling a need, or else they wouldn't exist, they say, and the loss of the clinics would have repercussions.
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.
An anti-Planned Parenthood campaign
The controversy surrounding Planned Parenthood picked up steam in January after antiabortion filmmaker Lila Rose released a set of "sting" videos showing an office manager helping a faux "pimp" get services for underage prostitutes. The film was part of "Expose Planned Parenthood" – a campaign by several antiabortion groups to stop federal funding of the organization.
Planned Parenthood says it doesn't use federal subsidies to fund abortions, which would be in violation of federal law. But opponents claim that offering abortion services as part of a comprehensive reproductive-health package means de facto taxpayer support of abortion.
Going forward, there are other legal complications with the Indiana law. Federal law prohibits states from picking and choosing which groups receive Medicaid dollars. Moreover, the American Civil Liberties Union claims in a legal filing that the law violates women's rights by curbing their right to choose their provider under Medicaid.
“It is unlawful, unnecessary, and cruel to deny these populations health services that they desperately need," said the ACLU's Indiana legal director, Ken Falk.
Indiana's Family and Social Services Administration has raised concerns that the law could jeopardize $4 million in Medicaid funding for family planning.