Planned Parenthood v. COMMISSIONER OF IND.
794 F. Supp. 2d 892
S.D. Ind.2011Background
- HEA 1210 enacted May 10, 2011, defunds abortion providers from health-service funding unrelated to abortion and alters informed consent requirements.
- PPIN is a Medicaid provider; it provides STD testing, cervical smears, contraception, and other services, with a small share of abortions funded privately.
- PPIN receives federal DIS grants for STD interventions and maintains contracts funded by federal grants routed through Indiana; these funds pass through the state.
- PPIN stopped DIS services and halted taking new Medicaid patients after HEA 1210; the law is already affecting operations and staffing.
- Plaintiffs sued the Commissioner and state agencies the day HEA 1210 was signed, seeking a preliminary injunction; the court held arguments and evidence on June 6, 2011.
- The court granted a preliminary injunction in part: defunding provision enjoined; informed consent provision (E) denied as applied; and informed consent provision (G) enjoined as applied to first-trimester abortions.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Does defunding violate Medicaid freedom of choice? | PPIN argues it unlawfully narrows choice of qualified providers. | State may exclude providers under § 1396a(p)(1) for reasons other than qualification; no private right of action required. | Yes, likely violates freedom of choice. |
| Is there a private right of action to enforce the Medicaid freedom-of-choice provision under § 1983? | § 1396a(a)(23) creates an enforceable right via § 1983. | Medicaid provisions do not unambiguously confer rights enforceable under § 1983; remedy is federal funding termination. | Yes, § 1983 right exists to enforce freedom of choice. |
| Is the defunding provision preempted by federal law as to DIS funds? | 42 U.S.C. § 247c preempts state eligibility restrictions for DIS grants. | States may set eligibility; spending clause preemption not shown. | Yes, likely preempts DIS funding provisions. |
Key Cases Cited
- O'Bannon v. Town Court Nursing Ctr., 447 U.S. 773 (U.S. 1980) (freedom of choice protects provider choice within qualified options)
- Blessing v. Freestone, 520 U.S. 329 (U.S. 1997) (three-prong Blessing test for enforceable rights under §1983)
- Harris v. Olszewski, 442 F.3d 456 (6th Cir. 2006) (right to choice is enforceable; deference to federal agency decisions discussed)
- Bruggeman ex rel. Bruggeman v. Blagojevich, 324 F.3d 906 (7th Cir. 2003) (freedom of choice limits; recipient elección among qualified providers)
- Bay Ridge Diagnostic Lab., Inc. v. Dumpson, 400 F. Supp. 1104 (E.D.N.Y. 1975) (injunctions tied to freedom of choice in Medicaid context)
- PhRMA v. Thompson, 362 F.3d 817 (D.C. Cir. 2004) (Chevron deference and agency interpretation of Medicaid plans)
- Gonzales v. Carhart, 550 U.S. 124 (U.S. 2007) (state may regulate in abortion context; informed consent considerations)
- Casey, 505 U.S. 833 (U.S. 1992) (state may require truthful, non-misleading information to ensure informed choice)
- Rounds, 530 F.3d 724 (8th Cir. 2008) (discusses 'objective scientific information' in fetal pain context; relevance to compelled speech)