Indiana Not Budging, Despite Threats from Obama Administration

By Dave Andrusko

Medicare and Medicaid Administrator Donald Berwick.

By Monday afternoon, when next we discuss the Obama administration’s heavy-handed attempt to coerce the state of Indiana, a federal judge will have heard Planned Parenthood of Indiana’s suit challenging a new law that denies state-directed funding for businesses and organizations performing abortions, except for hospitals or ambulatory surgical centers. The hearing, in front of U.S. District Judge Tanya Walton Pratt, is separate from the Obama administration’s full-bore assault on the measure which the Indiana General Assembly approved on April 27 and Gov. Mitch Daniels signed into law on May 10.

When you have the full resources of the federal government at your disposal, you can make life very difficult for any state. So far Indiana has not budged, even after receiving a politely threatening letter from Medicare and Medicaid Administrator Donald Berwick.

This week Berwick wrote Patricia Cassanova, the director of Indiana’s office of Medicaid Policy and Planning, saying the CMS would not approve changes to Indiana’s Medicaid plan because “Medicaid programs may not exclude qualified health care providers from providing services that are funded under the program because of a provider’s scope of practice.”  He added, “Such a restriction would have a particular effect on beneficiaries’ ability to access family planning providers.”

But Marcus Barlow, a spokesman for Indiana’s Family and Social Services Administration, told the National Journal, “The way the law was written, it went into effect the moment the governor signed.” He added in a telephone interview, “We were just advised by our lawyers that we should continue to enforce Indiana law.”

The Obama administration is broadly hinting that noncompliance could threaten the loss of $4 billion–its share to Indiana for Medicaid—and that other states could face the same fate. “We’ve sent out a bulletin to all of the states notifying them of the finding in Indiana,” Berwick said. “And I expect that states will comply.”

In a statement issued Wednesday, Indiana Congressman Marlin Stutzman pointedly noted that contrary to what Berwick had concluded, the new law will not change Medicaid services. “Indiana Family and Social Services Administration identified approximately 800 provider locations that will still provide non-abortion, health and family planning services under the new law. These facts are clear.”

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