I've been waiting for someone or something to stop state Republican-controlled legislatures from defunding Planned Parenthood. Surely, it can't happen, right? But it is. And what's worse, it's not just that states are passing legislation to curb abortions. They are proposing to take all the Medicaid money away from Planned Parenthood, including money for pregnancy counseling, screening tests for breast cancer, and all of the many non-abortion services that Planned Parenthood provides to women.
What have I done about it? I'm ashamed to say I haven't done much. It's kind of stunning, and I wonder how anyone can stop a Republican legislature bent on keeping the women of their state in a "permanent state of pregnancy" (hint it's hyperbole!).
This week, the Indiana legislature passed exactly this type of legislation (which the erstwhile Presidential candidate Gov. Mitch Daniels signed), going much farther than simply restricting Planned Parenthood from performing abortions. After all, federal law already restricts Medicaid funding for abortions except in cases of rape, incest or health of the mother. The Indiana legislature was not content with this federal restriction, it decided to punish Planned Parenthood and keep the clinics from providing the other services that women go to their clinics to obtain. Forbes magazine states:
In the state of Indiana, Planned Parenthood operates 28 health facilities, only 4 of which offer abortion services. The remaining 24 provide some 85,000 Indiana women with important preventative health care along with other critical services including gynecological exams, breast cancer testing, birth control, and treatment for sexually transmitted diseases and infections - but no abortion procedures.In fact, only 6% of the funds spent by Planned Parenthood in Indiana go towards abortion services.
The New York Times story noted that the law ultimately denies Planned Parenthood from getting any state contracts:
It prohibits state agencies from entering contracts with or making grants to "any entity that performs abortions or maintains or operates a facility where abortions are performed." It also terminates existing state contracts with such entities. The law does not apply to hospitals.
Since federal money for family planning services at the state level is about 90% of the federal-state share, Indiana may be effectively refusing almost all of the money that supports family planning in the entire Medicaid program. The rationale of the legislature was that women could go elsewhere for these services so they didn't need the Planned Parenthood clinics. In fact, even if you are insured, your primary care physician might provide some of these services but not all and likely at a higher price than Planned Parenthood. And if you have no insurance, you are plain out of luck. It is hard enough to find any provider that will take a Medicaid patient, but providers who will give basic exams, screen discretely for sexually transmitted diseases, and provide pregnancy counseling are few and far between, especially in rural areas.
Fortunately, this type of decision at the state level about Medicaid funding is subject to federal approval. What power does the federal government have? They can withdraw ALL federal money to the state for its Medicaid program, not just money for family planning. And it is clear that the Obama Administration will push this issue as far as they legally can. Indiana, however, can still refuse federal funding for Medicaid, and it may come to that. After all, the recipients of these services are poor women. The Indiana legislature apparently cares not a whit about them.
Robert Pear of the New York Times notes, "Asked for comment on the Indiana law, the federal Centers for Medicare and Medicaid Services provided this statement, cleared by the White House: "Federal law prohibits federal Medicaid dollars from being spent on abortion services. Medicaid does not allow states to stop beneficiaries from getting care they need -- like cancer screenings and preventive care -- because their provider offers certain other services. We are reviewing this particular situation and situations in other states."
In addition to federal action, there is some local court action pending, although a district judge denied Planned Parenthood's request for a temporary restraining order.
The Indiana law is being implemented right now, despite the suits and threats of denial of federal funding. So a lawsuit has been filed by the ACLU and Planned Parenthood on the basis of restriction of freedom of choice of provider. The courts will decide on this issue within a few weeks.
If Indiana succeeds in this draconian withdrawal of women's health services, it is not hard to imagine that other states will follow. In fact, states such as Kansas, North Carolina, Oklahoma, Texas, Tennessee and Wisconsin are already considering or are in the process of passing this type of legislation. If you live in these states, what are you doing about it?
There have been stories about the various state efforts to defund Planned Parenthood and ban abortions. The New York Times, The Washington Post, The Huffington Post have all carried stories in the past few weeks. But I sense a kind of paralysis among women of all ages about what to do.
Here are few things you can and must do if you care about this issue.
1) Contact Planned Parenthood in your state. You can google them and find out from their website what is pending in your state.
2) Donate to Planned Parenthood and any other organizations such as the ACLU that are fighting these laws.
3) Write a letter to your local newspaper. You can do it online for most newspapers. Keep it simple. Just say for all the talk that Republicans make about "freedom of choice" in health care, this takes away your freedom. It is also an intrusion by the state into a medical issue that should remain between you and your doctor.
4) Stay aware and do all you can to spread information on Facebook and Twitter and email about what is going on. These are all "elected" officials who can be unelected in the next election!
5) And tell us what you do! Share your experiences in your state in your comments right here on this blog so that other women can learn from your situation.
This is nothing less than an assault on all of us, whether or not we ever use Planned Parenthood services.
UPDATE: Check out this blog by the President of Planned Parenthood Action Fund, Cecile Richards, for some additional facts about the Indiana legislation and its impact on women in that state. http://www.huffingtonpost.com/cecile-richards/governor-mitch-daniels-wo_b_866273.html
UPDATE #2: As of June 2, it appears that if Indiana continues with its current policies to defund Planned Parenthood and defy the rules set by the federal government for receipt of Medicaid funding, it will be at risk of losing $4.3 BILLION of its overall $5.9 Billion Medicaid budget. Will Indiana put all of its Medicaid programs at jeopardy over this?