“It’s outrageous that Governor Mitch Daniels has signed a dangerous bill that would have a devastating impact on women’s health and take away health care from thousands of women in Indiana, leaving them at greater risk for undetected cancers, untreated infections and unintended pregnancies.
“Clearly, Governor Daniels, who has called for a truce on social issues, would rather play politics with women’s health than show leadership and fiscal responsibility by rejecting a bill that will ultimately cost the state millions in federal funding.
“If Governor Daniels chooses to run for president, women across this country will not forget that he failed them when they needed him.”
NOTE: Planned Parenthood will immediately file litigation in federal court against this bill, including requesting an immediate injunction to prevent the law from taking effect while the litigation proceeds. Planned Parenthood will argue that the law is unconstitutional and violates federal law on the following grounds:
*The law deprives Medicaid patients of their choice of health care provider in violation of federal law.
*It denies Planned Parenthood of Indiana contracts and grants involving federal money just because it provides a constitutionally protected medical procedure.
*It would force health care professionals to make statements to patients that are not medically and scientifically based — violating the First Amendment of the U.S. Constitution.
The Facts on Indiana’s Move to Bar Planned Parenthood from Federal Funding
Indiana Governor Mitch Daniels has just signed legislation that would bar Planned Parenthood from providing health care to women in Indiana who benefit from several streams of federal family public health funding. This law, if it remains in place, would undermine the ability of low-income women to obtain screenings for cervical cancer, birth control, and other preventive health care, such as testing for sexually transmitted infections (STIs), including HIV.
These legislative attacks are part of a larger effort to end family planning and undermine Planned Parenthood. Similar efforts are underway in state legislatures in Oklahoma, North Carolina, Tennessee, Kansas, and Texas. If these efforts succeed, the result will be drastically reduced options for preventive care and family planning for low-income women and those who live in rural areas.
Here is the background on the Indiana law and other states targeting Planned Parenthood and family planning:
House Enrolled Act (HEA) 1210 is an Omnibus Abortion Bill that includes a provision to cut off all funds to Planned Parenthood. The last-minute amendment to defund Planned Parenthood was introduced by State Sen. Scott Schneider on April 18, 2011.
The defunding provision bars the state from entering into contracts with, or granting funds to, any entities (other than hospitals and ambulatory surgical centers) that provide abortions. While Planned Parenthood is not named, there is no doubt that the provision is aimed at Planned Parenthood of Indiana.
Public Health Policy
HEA 1210 does even more to damage to public health policy in Indiana by
• requiring that doctors provide medically inaccurate information to their patients
• banning abortion after 20 weeks post-fertilization, even though this is approximately two weeks earlier than when states are permitted under existing law.
What does this mean for patients?
At immediate risk are as many as 22,000 patients, and as many as 13 health centers are in jeopardy of closing in the future if the courts do not intervene. These patients could lose access to basic preventive reproductive health care that reduces the number of unintended pregnancies and thus the need for abortion.
Specific funding sources at risk: Medicaid, a Disease Intervention Specialist (DIS) Grant, Title V of the Social Security Act Grant, Title XX of the Social Security Act Grant. Total funds at immediate risk are in excess of $2 million.
Instead of adequately funding health care and sex education that would prevent unintended pregnancies, Indiana has one of the highest rates of births by mothers who are covered by Medicaid — more than one in two Indiana births is covered by Medicaid. Planned Parenthood of Indiana estimates the potential additional costs to the state at $68 million.
Planned Parenthood will file litigation in federal court to obtain a temporary restraining order to prevent the law from taking effect while the litigation proceeds. Planned Parenthood is arguing that the law is unconstitutional and violates federal law on the following grounds:
• The law deprives Medicaid patients of their preferred health care provider in violation of federal law.
• It denies Planned Parenthood of Indiana contracts and grants involving federal money just because it provides a constitutionally protected medical procedure.
• It would force health care professionals to make statements to patients that are not based on medicine or science — violating the First Amendment of the U.S. Constitution.
Planned Parenthood is fighting for our patients’ rights and their access to lifesaving preventive care.
According to Governor Daniels’ own state health agency, the Family and Social Services Administration, federal law prohibits state Medicaid plans from picking and choosing which qualified family planning providers can participate in Medicaid. In other words, the Indiana state agency is saying that Indiana cannot bar Planned Parenthood from participating in the state Medicaid program.
And according to the federal Centers for Medicare and Medicaid Services, “If the state denies payment to these providers, that would be illegal,” said Mary Kahn, a spokeswoman for the Centers for Medicare and Medicaid Services, the U.S. agency that administers the two huge healthcare programs. “There are some options available to us. But I can't say what action will be taken to bring the state into compliance. All we can say now is we will review the matter once Indiana decides.” (Los Angeles Times, May 3, 2011)
Beyond Indiana: Women under Attack
Despite a bipartisan vote in the United States Senate to defeat a proposal to bar Planned Parenthood from providing health care to women through Medicaid and other federal programs, Planned Parenthood and women’s access to health care, are still under attack. Across the country, state legislatures — like those in Indiana, Texas, and North Carolina — are either considering or have passed bills that would cut off funds for women’s health care. And in Oklahoma, legislators have even gone so far as to sacrifice funds for the Women, Infant, and Children’s program (WIC) in order to defund Planned Parenthood.
These bills cynically place political ideology over basic health care, putting the lives of millions of women and families at risk. As we saw during the federal debate, these attacks are bad health policy, bad fiscal policy, and bad politics.
KANSAS: The Kansas legislature has moved to prohibit Planned Parenthood from receiving federal Title X family planning dollars in its 2012 budget. A final vote on the budget is expected next week.
NORTH CAROLINA: On May 3, the North Carolina House passed a budget including an amendment that would prohibit the state from entering into grants or contracts with Planned Parenthood. This would prevent Planned Parenthood from receiving federal Title X funds. Planned Parenthood currently receives that funding to provide preventive health care services, teen pregnancy prevention programs, and affordable contraception. North Carolina’s nine Planned Parenthood health centers provide health care to more than 25,000 women and men. In a survey conducted by Public Policy Polling, 57 percent of North Carolina voters opposed the effort by House Republicans to prohibit state funding to Planned Parenthood.
OKLAHOMA: Oklahoma House members moved to deny Planned Parenthood from participating in the Women, Infants, and Children (WIC) program. Planned Parenthood receives WIC funding to provide nutrition vouchers for families participating in the affiliate’s prenatal and pediatric programs. The measure does not identify Planned Parenthood specifically, but rather limits WIC funding to select groups, excluding Planned Parenthood and, unintentionally, eight other WIC recipients. We ultimately expect the language of this measure to be amended to solely exclude Planned Parenthood.
TENNESSEE: Last week the General Welfare, Health & Human Resources committee of the Tennessee Senate approved an amendment for the state budget that would ultimately deny Title X funding to Planned Parenthood. Without this funding, the low-income, uninsured women and teens in Memphis and Shelby County will be denied lifesaving STI and HIV screenings, birth control, and basic health care, leading ultimately to more unplanned pregnancies, underweight births, and infant mortality (a pressing local issue). The bill is expected to pass the legislature and be signed by the governor in the next few weeks.
TEXAS: Texas is in the process, through a combination of rule making and legislation, of excluding Planned Parenthood from the state Women’s Health Program (funded through a Medicaid family planning waiver). The legislative piece is headed to the Senate floor. Planned Parenthood currently provides nearly 50 percent of the services provided under this program. The legislation adds a high stakes threat: if Planned Parenthood successfully litigates against the ban, Texas would eliminate the Medicaid Women’s Health Program entirely. On May 3, Planned Parenthood sent a letter to Republican State Sen. Robert Deuell, who introduced the bill, indicating it will pursue all necessary steps to continue providing care to low-income women, including litigation.
WISCONSIN AND NEW JERSEY: In addition, GOP Governors Scott Walker in Wisconsin and Chris Christie in New Jersey have slashed funds for family planning in their budgets. Walker — whose war on unions has made him one the most divisive figures in the country — has proposed a budget that completely eliminates family planning from the state budget, which would in turn put federal grants in jeopardy. In New Jersey, Christie’s 2010 budget, which eliminated $7.4 million from the budget for basic reproductive health care, forced at least five family planning health centers in the state to close.
Lawmakers have dressed up their ideological proposals as cost-cutting initiatives. The damage these bills will cause to women’s health will be catastrophic — not to mention extremely costly.
BACKGROUND: Gov. Daniels “Truce” on Social Issues
Mitch Daniels once declared a truce in the culture wars. He said that maintaining a smart fiscal house was better policy than going after hot-button social issues. But now that he might run for president, he’s siding with anti-choice ideologues who want to wipe out family planning programs.
At the same time, he’s still trying to play the levelheaded guy who wants to stay above the fray on social issues. Why?
June 8, 2010; Mitch Daniels declares truce in the war on social issues.
January 2011: Observers look to Mitch Daniels as a serious potential 2012 presidential contender.
April 25, 2011: Haley Barbour drops out of the presidential race,increasing likelihood of a Mitch Daniels run.
April 27/28, 2011: National and local media weigh in on the decision facing Governor Daniels:
Muncie Star Press editorial: “Daniels faces a dilemma: Sign the bill, and he becomes the hero of the conservative cultural movement. He also negates his truce on the so-called social issues he called for last year. … Daniels must decide whether the state's fiscal needs outweigh the demands by social conservatives.”
MSNBC First Read: “As National Journal says this morning, we’re about to find out how Indiana Gov. Mitch Daniels defines his ‘truce’ and how serious is he about running for president. … the fiscal hawk in Daniels may dictate him to veto it, since the bill would cost the state MORE money to implement.”
Politico’s Ben Smith: “To veto the bill would be to declare war on the social right, and to head into any primary with a target on his back. To sign it is to make peace with them, but to head into any future general election defined as an anti-abortion candidate, and as the enemy of an organization that, current polling suggests, most women view positively.”
TIME’s Amy Sullivan: “Daniels would have an easier choice if the bill addressed public funding of abortion. But it doesn’t. Public funds are already prohibited from being used to fund abortions. … Opponents of Planned Parenthood know they hold a minority view, which is why they try to tie their defunding efforts to abortion legislation or to highlight Planned Parenthood’s abortion services, in an effort to conflate abortion and contraception.”
Mother Jones’ Kate Sheppard: “How Daniels handles this truce-breaking legislation will be an important test of how seriously he takes his call for peace.”
National Journal’s Tim Alberta: “If he vetoes the bill, Daniels effectively confirms the suspicions of social conservatives who cringe at the idea of compromising on sensitive issues like abortion — and in doing so,provides the strongest indication yet that he's putting state governance over presidential politics.”
April 29, 2011: Mitch Daniels indicates he will sign a bill defunding Planned Parenthood, in his state, an ideologically driven policy agenda that will potentially add to the state deficit and undermines low-income’s women’s ability to obtain cervical cancer screenings, birth control and other preventive health care.
The Question Remains: Which Gov. Daniels Is Showing Up For Work Today?
Is it the Governor Daniels that says social issues aren’t pressing and instead we should focus on balancing the budget? Or is it the Governor Daniels who’s pandering to the Right Wing ideologues?