Indiana likely to strip family planning dollars from Planned Parenthood, but where that money would go is unclear
Based on Indiana Republican Gov. Mitch Daniels’ call last summer for a “truce on social issues,” for some, it came as a surprise that he wasted no time announcing his support for House Bill 1210, which the governor said Friday he will sign the minute it hits his desk, making Indiana the first state to deny all federal family planning and health care funding to a Planned Parenthood state affiliate.
But what’s unclear is where the money that would have gone to these 28 Planned Parenthood of Indiana clinics will go. Even Daniels’ office is not quite sure how the defunding will work, especially with regard to Medicaid, or exactly how much money clinics will lose.
“There is about $20 million for these services in a 90-10 split with the federal government,” governor spokesperson Jane Jankowski said in an e-mail. “Should the federal government reduce funding to the normal Medicaid split of 66-34, the shortfall would be approximately $3.9 million. If the federal government provides no funding, the figure is about $17 million.”
In an initial fiscal impact statement (PDF) about the bill, advised by fiscal analyst Kathy Norris, Indiana legislators conceded they are uncertain how the new law will interact with federal regulations concerning the Medicaid program.
From the statement:
Assuming the Office of Medicaid Policy and Planning (OMPP) cannot implement the provisions of the bill (due to federal supremacy), there would be no impact on state expenditures for Medicaid and service contracts.
The bill would impact a current Planned Parenthood contract with Madison State Hospital (MSH) and Planned Parenthood grants and contracts made by FSSA for the Social Services Block Grant (SSBG) and ISDH. It may also prohibit Planned Parenthood from participating as a Medicaid provider.
The Medicaid provider agreement is a contract. This bill could potentially impact Planned Parenthood’s ability to bill for Medicaid services. OMPP reports that in FY 2010, Planned Parenthood clinics in Indiana were paid $195,915 in Medicaid fee-for-service claims, and $1,167,748 in claims were paid by the managed care organizations.
As far as what will happen to the money that does not go to Planned Parenthood, Jankowski said she did not know.
But Planned Parenthood has a pretty good idea of what they could lose.
Betty Cockrum, president and CEO of PPIN, told The American Independent that the affiliate stands to lose about $3 million in federal funding. Broken down, she said that about $2 million comes from Title V, X and XX grants, from which about $150,000 goes to HIV/AIDS prevention for women and men. PPIN then receives about $1 million in Medicaid funding, which Cockrum said provides family services to about 9,300 people. Altogether, she said the cuts would impact about 22,000 Hoosiers.
But Cockrum said Planned Parenthood will file an injunction the second the governor signs the bill; they are filing actions against several provisions in the bill, including one provision that compels doctors to tell women what some believe is medically inaccurate information about abortion, such as that it directly leads to breast cancer.
“There is so much about House Bill 1210 that is horrible and frustrating,” Cockrum said. “We’re going into this [injunction] with confidence. We have an exellent team of lawyers.”
PPIN has also sparked statewide rallies to encourage the governor to veto the bill.
Daniels has defended the bill in the face of critics who say the new law will result in lost health care for women. In a statement released last week, his office reviewed access to services across Indiana and confirmed that non-abortion reproductive health services will be available in all 92 counties. The governor’s office says the law will affect seven entities in Indiana which have a total of 34 locations in 21 counties throughout the state (Cockrum said six out of those seven entities are abortion providers only, and do not receive any federal funding). And in those 21 counties, Daniels’ office said there are approximately 800 Medicaid providers eligible to provide Medicaid clients with health and family planning services.
Cockrum said that she does not believe all 800 providers offer the range of services Planned Parenthood clinics do, and has heard legislators offer a crisis pregnancy center as an example of a place where a woman could go to seek her family planning needs. But CPCs are not known for providing birth control or pap smears.
Of the 28 centers in PPIN’s network, four of them offer abortion services. Eight of the centers, located in mostly rural areas, rely entirely on federal funding and still collectively run at a $90,000 operating loss, Cockrum said. The rest of the money is made up by private funding.
“If we were to lose the entire $3 million, it would be very difficult for those eight centers,” Cockrum said. Though she is confident about PPIN’s lawsuit, she said there is a possibility some centers might have to close.
Daniels has offered a solution to Planned Parenthood’s funding dilemma: ”Any organization affected by this provision can resume receiving taxpayer dollars immediately by ceasing or separating its operations that perform abortions.”
The new law will not affect Medicaid funding for the state’s hospitals or ambulatory surgical centers.
Now that Indiana’s legislative session has adjourned, Daniels, who is finishing his final term, will soon announce whether or not he will run for president. Speculated to take his place as governor is Indiana’s own U.S. Rep. Mike Pence, who authored the failed bill to defund Planned Parenthood on a federal level. Pence was expected to announce his gubernatorial run on Monday but postponed a press conference in light of the Sunday killing of Osama bin Laden.