States aiming to restrict abortion access were dealt a setback Tuesday when the US Supreme Court refused to consider an appeal of a lower court decision blocking an Indiana measure that would have prohibited Medicaid funding for health providers that perform abortion services.
The decision is likely to affect a similar proposed ban making its way through the legislature in Arizona. Both states argue that taxpayers are inadvertently funding abortions when health-care clinics like Planned Parenthood receive Medicaid funding for services other than abortion. Federal law prevents the direct funding of abortion services, but the measures in Indiana and Arizona are seen as going a step further in stripping Medicaid dollars from any organization that offers abortion.
Opponents of the measures say the strategy denies low-income patients the right to obtain health care from their provider of choice. The Indiana chapter of Planned Parenthood, which operates 28 clinics in the state, says that it serves more than 9,300 Medicaid patients annually for preventive-care services that include cancer screenings, routine medical exams, and birth control.
Betty Cockrum, president and CEO of the Indiana chapter, released a statement Tuesday, characterizing legislators’ strategy as “trying to score political points and wasting taxpayer dollars.” Medicaid funding represents about 20 percent of the group’s annual budget of $15 million.
The Indiana ban passed in June 2011 but was immediately blocked by the US District Court in Indianapolis. In signing the law, then-Indiana Gov. Mitch Daniels (R) said he was confident “that all non-abortion services … will remain readily available” across the state and that, if the affected organizations eliminated abortion from their roster, they would once again become eligible for federal dollars.
“Any organization affected by this provision can resume receiving taxpayer dollars immediately by ceasing or separating its operations that perform abortions,” he said.
In October 2012, the US Court of Appeals for the Seventh Circuit in Chicago upheld the lower court’s decision, which prompted the state to appeal to the higher court this year.
Indiana Attorney General Greg Zoeller said in a statement released Tuesday he would investigate “any remaining legal avenues” to uphold the ban and stressed that the issue was one of states’ rights, not an attack on abortion access.
“My office always contended this is ultimately a dispute between the state and federal government, not between a private medical provider and the state,” he said.
Even though a federal judge struck down a similar ban in Arizona last year, Gov. Jan Brewer (R) is including language along such lines as part of a plan to expand her state’s Medicaid program under the Affordable Care Act. The plan passed the state Senate two weeks ago and faces an uncertain future in the House.
Tuesday’s high-court move may dampen similar efforts to restrict Planned Parenthood’s ability to offer abortion services, says Elizabeth Nash, the state issues manager at the Guttmacher Institute, a nonprofit in Washington that tracks abortion issues. But, she adds, such efforts will probably be replaced with other measures that are written with the same purpose – such as creating a priority system for how Medicaid dollars can be spent, or instituting restrictions that are intended to separate abortion from other family-planning services.
“There are other ways that have been used to varying degrees of success to essentially keep Planned Parenthood out of public dollars,” Ms. Nash says.
Earlier this month, Indiana Gov. Mike Pence (R) signed into law a bill restricting access to a so-called abortion pill, which accounts for about one-fourth of US abortions, according to the Guttmacher Institute. The new law requires clinics that offer pill-induced abortions to meet the same standards as clinics that provide surgical abortions.
Planned Parenthood says the law is intended to target a single clinic in Lafayette, Ind., which is the only clinic in the state that offers nonsurgical abortions.