In the race to be the first, the Indiana GOP plowed through common sense and internal opposition to pass a law stripping Planned Parenthood of public funding. When signing the bill, Indiana Gov. Mitch Daniels (R) said non-abortion services would “remain readily available” from other providers. In reality, by signing the law, Daniels jeopardized federal funding for all family planning and health care providers and, as a result, access to health care for thousands of low-income Hoosiers.
Because the law bans Planned Parenthood from receiving Medicaid funds in Indiana, it violates a federal law that prevents any state from denying payment to health care clinics that provide a “constitutionally protected service.” Finding Indiana in blatant violation of this law, the U.S Centers for Medicare & Medicaid Services Administrator Don Berwick rejected the law and notified the state that it may lose “all federal funding of its Medicaid program.” But rather than reconsider the drastic move, Indiana will “defy” CMS and continue to implement the law:
Indiana plans to defy an Obama administration letter and continue barring Planned Parenthood from receiving federal funding — a move that, if continued, could cost the state more than $4 billion in Medicaid funds. [...]
The Indiana Family and Social Services Administration plans to continue implementing the legislation, signed by Gov. Mitch Daniels last month, that defunded Planned Parenthood.
“For now, our lawyers advise us that we must continue to follow the law the Indiana General Assembly passed,” says Marcus Barlow, director of communications for FSSA. “We will seek guidance from the attorney general on how to proceed going forward.”
A CMS source told Politico that “the entirety of Indiana’s federal Medicaid funding” is at stake should they violate federal law. Last year, Indiana received $4.3 billion in federal funding which “accounts for about two-thirds of the state’s $5.9 billion Medicaid budget.” About $3 million of that funding goes to Indiana’s 28 Planned Parenthood clinics, which, according to Planned Parenthood of Indiana, served about 9,300 low-income patients last year. Of these clinics, only four provide abortion services. What’s more, only 3 percent of their services involve abortions. In going to such an extreme to prohibit one group’s rare practice of a constitutionally protected service, Indiana is imperiling the health care of a great number of Hoosiers to make a political point.
Of course, for many in the GOP, the evisceration of Medicaid seems to be an end goal. At the beginning of this year, GOP governors sought leeway to cut down on their Medicaid rolls through exemption from the health care reform law. House Budget Chairman Paul Ryan’s (R-WI) budget plan seemed to deliver by turning Medicaid into a block grant program, effectively allowing states to cut eligibility and provide less coverage. Idaho Gov. Butch Otter (R) took matters into his own hands and signed an executive order in April that will essentially end Medicaid in his state.
But, as Planned Parenthood President Cecile Richards notes, CMS’s rebuke “serves as a warning to other states” considering a similar ploy with Medicaid. While Kansas, North Carolina, and Texas are toying with similar legislation, Tennessee has already “backed off attempts to defund Planned Parenthood specifically because of concerns over constitutionality.”