Federal Judge Blocks Indiana Law To Defund Planned Parenthood

A setback for Planned Parenthood opponents.

Late yesterday, a Federal Judge in Indianapolis issued an injunction against an Indiana law that blocks Planned Parenthood from received state Medicaid funds:

WASHINGTON — A federal judge ruled Friday that the State of Indiana could not cut off money for Planned Parenthood clinics providing health care to low-income women on Medicaid.

The judge, Tanya Walton Pratt of the Federal District Court in Indianapolis, blocked provisions of a new state law that penalized Planned Parenthood because some of its clinics performed abortions. The law, she said, conflicts with the federal Medicaid statute, which generally allows Medicaid beneficiaries to choose their health care providers.

Planned Parenthood provides services other than abortion, including family planning and screenings for cancer and sexually transmitted diseases.

In issuing a preliminary injunction late Friday, Judge Pratt said the state law “will exact a devastating financial toll on Planned Parenthood of Indiana and hinder its ability to continue serving patients’ general health needs.”

The law took effect immediately when it was signed on May 10 by Gov. Mitch Daniels, a Republican.

As of June 20, the judge said, Planned Parenthood of Indiana stopped treating its Medicaid patients and laid off two of its three specialists in sexually transmitted diseases. The judge said that “only a small percentage” of Planned Parenthood’s services involved abortion.

“States do not have carte blanche to expel otherwise competent Medicaid providers,” Judge Pratt said. And “there are no allegations that Planned Parenthood of Indiana is incompetent or that it provides inappropriate or inadequate care.”

The ruling has national significance. At least a half-dozen states have taken aim at Planned Parenthood because its clinics perform abortions, about one-fourth of all those performed in the United States.

Judge Pratt gave “some measure of deference” to a ruling by the Obama administration, which on June 1 denied approval for the changes that Indiana wanted to make in its Medicaid program.

The federal government could terminate some or all of Indiana’s Medicaid money if the state persisted in violating federal Medicaid law.

“The public interest tilts in favor of granting an injunction,” Judge Pratt declared. “The federal government has threatened partial or total withholding of federal Medicaid dollars to the State of Indiana, which could total well over $5 billion annually and affect nearly one million Hoosiers.”

On it’s surface this sounds like a simple issue of Federal law trumping state law. Federal Medicaid laws prohibit states from discriminating against qualified providers, and there doesn’t seem to be any evidence or allegation that Planned Parenthood is not qualified to provide the non-abortion services that it provides at its clincs. Two excerpts from Judge Pratt’s opinion are instructive:

Central to the present dispute, a state plan must provide that “any individual eligible for medical assistance . . . may obtain such assistance from any institution, agency, community pharmacy, or person, qualified to perform the service or services required . . . who undertakes to provide him such services…”. 42 U.S.C. § 1396a(a)(23) (emphasis added) (hereinafter, “‘freedom of choice’ provision”). This “freedom of choice” provision has been interpreted by the Supreme Court as giving Medicaid recipients the right to choose among a range of qualified providers, without government interference. O’Bannon v. Town Court Nursing Ctr., 447 U.S. 773, 785 (1980).

(…)

The actual language of the “freedom of choice” provision supports the view that the defunding provision unlawfully narrows Medicaid recipients’ choice of qualified providers. To reiterate, the “freedom of choice” provision provides that “any individual eligible for medical assistance … may obtain such assistance from any institution, agency, community pharmacy, or person, qualified to perform the service or services required … who undertakes to provide him such services.” 42 U.S.C. § 1396a(a)(23) (emphasis added). Further, the regulations clarify that “recipients may obtain services from any qualified Medicaid provider that undertakes to provide the services to them.” 42 C.F.R. § 431.51(a)(1) (emphasis added). If the Commissioner’s interpretation were adopted, it would undoubtedly restrict the rights of Medicaid patients to obtain services from “any qualified Medicaid provider.” This would arguably rob the “freedom of choice” provision of any real meaning. In sum, a strong argument exists that Plaintiffs’ interpretation is superior in terms of giving effect to every word of the “freedom of choice” provision. See Moskal v. U.S., 498 U.S. 103, 109 (1990) (“a court should give effect, if possible, to every clause and word of a statute.”) (citations and internal quotations omitted).

In other words, this decision has nothing to do with abortion per se but with the fact that if Indiana wishes to participate in Medicaid and receive funding from the Federal Government, it must comply with Federal law. Obviously, this isn’t the end of the case. Yesterday’s ruling itself is only an injunction and a final ruling on the merits is months away, after that appeals will inevitably follow. However, this decision is likely to blunt the efforts of other states to follow Indiana’s lead and cut off Medicaid funding to Planned Parenthood.

A copy of the opinion is below:

Planned Parenthood of Indiana v. Indiana Dept. Of Health et al

FILED UNDER: Health Care, Law and the Courts, US Politics
Doug Mataconis
About Doug Mataconis
Doug holds a B.A. in Political Science from Rutgers University and J.D. from George Mason University School of Law. He joined the staff of OTB in May 2010. Before joining OTB, he wrote at Below The BeltwayThe Liberty Papers, and United Liberty Follow Doug on Twitter | Facebook

Comments

  1. Hey Norm says:

    The disconnect here is that republicans are all fir freedom of choice…as long as it’s their choice. What happened to the folks with tea bags dangling from their hats only caring about fiscal issues?

  2. John Peabody says:

    I hate to be this simplistic, but there’s a radio host that says, “if you’re against abortion- don’t have one”.

  3. hey norm, you should check the record on your turntable, all we get is the same message over and over.

  4. steve says:

    Indiana should just go ahead and not collect the federal Medicaid money. Let the people of the state vote on whether or not they like the results.

    Steve

  5. mantis says:

    Today’s Conservative platform:

    A) More cancer and less early detection
    B) More STDs
    C) More unwanted pregnancies
    D) A public less educated about their reproductive systems

    And since it’s Planned Parenthood and Medicaid,

    E) All of the above in greater magnitude for poor people, because screw them.

    Planned Parenthood provides cancer screening, Pap tests, STD testing, birth control, and education, and none of those things has anything to do with abortions, unless they are helping to reduce the number of them. Conservative opposition to what Planned Parenthood does has nothing to do with abortion, and everything to do with a desire to control women’s bodies, and make poor women suffer and die as much as possible. No other logical conclusion can be reached.

    Every day I thank the founders for having the wisdom to create a powerful independent judiciary.

  6. george says:

    hey norm, you should check the record on your turntable, all we get is the same message over and over.

    Possibly, but he’s right. Its hard to reconcile the desire for small gov’t and individual freedom with the desire to limit what people can do with their own bodies.

  7. Davebo says:

    Why don’t we just defund Indiana?

    Bye Bye Ethanol

  8. DMan says:

    Most Republicans and Conservatives aren’t as confusing as people make them out to be. It’s quite simple. They have more principled beliefs than most people. They don’t rigorously challenge their social beliefs because these are the facts they have been taught early on from their parents and churches. To question these is to question certain morals to them, and basically they fear that slippery slope of moral questioning. You can see why they would fear science and academia, which are built on the foundations of questioning and testing your beliefs.

    Their economic beliefs are probably secondary to their moral beliefs, in that given a choice between no regulation or a regulation that is in line with their moral belief, they’ll usually choose the later. Nonetheless they still have strong Americanized economic beliefs that can be broken down into the idea that regulations are generally bad, as they put limitations on the individual, and the sum of individual decisions is usually good when compared with the ability of a regulatory agency to decide what is good and how to control for it.

    I wouldn’t say all Republicans operate this way, and none operate this way consistently (humans acting consistently in highly variable situations just does not happen). But it’s a general approach to understanding the motivations and defenses of most Republicans.

  9. ponce says:

    Not a good week for America’s religious fanatics.

    Let’s hope they finally manage to nominate one of their own for 2012.

  10. OzarkHillbilly says:

    Doug: thanx.

  11. Hey Norm says:

    Austin…I’m not the one that keeps playing the same tune.

  12. anjin-san says:

    regulations are generally bad, as they put limitations on the individual corporation, and the corporations ability to screw individuals and the public at large.

    FTFY

  13. A voice from another precinct says:

    @an-jin: having grown up with the species, I understand your point, but have to note that they generally don’t distinguish between individuals and corporations. Giving the same protections to corporations as to individuals is necessary because “aren’t corporations made up of individuals?”

    The left does the same calculus on questions of national policy–if it would be immoral for an individual to do X it will also be immoral for a nation to do so based on the same logic.

  14. An Interested Party says:

    If corporations are the same as people, what is so terrible about regulating them? Do we not regulate what individuals can do so they don’t harm others? Why can’t the same rationale be used for corporations? By the way, the main purpose of a corporation is to make money, correct? Everything else is secondary, right? That’s some pretty amoral “people” we’re talking about…