June 2, 2011

The Obama administration has rightly decided to reject a mean-spirited and dangerous Indiana law banning the use of Medicaid funds at Planned Parenthood clinics, which provide vital health services to low-income women. The law, signed by Gov. Mitch Daniels of Indiana in May, is just one effort by Republican-led state legislatures around the country to end public financing for Planned Parenthood — a goal the House Republicans failed to achieve in the budget deal in April. The organization is a favorite target because a small percentage of its work involves providing abortion care even though no government money is used for that purpose. Governor Daniels and Republican lawmakers, by depriving Planned Parenthood of about $3 million in government funds, would punish thousands of low-income women on Medicaid, who stand to lose access to affordable contraception, life-saving breast and cervical cancer screenings, and testing and treatment for H.I.V. and other sexually transmitted diseases. Making it harder for women to obtain birth control is certainly a poor strategy for reducing the number of abortions. On Wednesday, the administrator of the federal Centers for Medicare and Medicaid Services, Donald Berwick, said the Indiana law, which is already in effect, violates federal Medicaid law by imposing impermissible restrictions on the freedom of Medicaid beneficiaries to choose health care providers. Although Mr. Berwick’s letter to Indiana officials did not say it explicitly, Indiana could lose millions of dollars in Medicaid financing unless it changes its law. In a bulletin to state officials around the country, the Medicaid office warned that states may not exclude doctors, clinics or other providers from Medicaid “because they separately provide abortion services.” So far, Indiana isn’t budging. The issue will be taken up on Monday in federal court in Indiana where Planned Parenthood has filed a suit challenging the state’s action on statutory and constitutional grounds. The organization properly argues that it may not be penalized for engaging in constitutionally protected activities, like providing abortion services with its own money. The Obama administration’s opposition to the Indiana law could help deter other states — including North Carolina, Texas, Wisconsin and Tennessee — from moving forward with similar measures to restrict payments to Planned Parenthood, either under Medicaid or Title X, the main federal family planning program. Kansas, for example, has enacted provisions to block Planned Parenthood from receiving any Title X money. The measures against Planned Parenthood come amid further efforts to limit access to abortion. Just since April, six states — Indiana, Virginia, Nebraska, Idaho, Oklahoma and Kansas — have enacted laws banning insurance coverage of abortion in the health insurance exchanges created as part of federal health care reform, bringing the total to 14 states. Two states — Arizona and Texas — joined three others in making ultrasounds mandatory for women seeking to terminate pregnancies. Bills expected to be signed soon by Florida’s Republican governor, Rick Scott, contain both types of provisions. Many of these fresh attacks on reproductive rights, not surprisingly, have come in states where the midterm elections left Republicans in charge of both chambers of the legislature and the governor’s mansion.