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Indiana’s Free Birth Control Law Never Implemented

Posted by: Linda Carbonell on November 14, 2011.

Mitch Daniels, Governor of Indiana when they dropped the ball

Six years ago, the state of Indiana passed a law intended to reduce the number of unintended pregnancies and the state costs that go with them – through obstetrical care, pediatric care and welfare. It was estimated that the law, which provided for free birth control for low income women, would cost the state $1.36 million and save it $8.1 million.

Then the bureaucracy got in the way

Right now it’s a case of he said/she said between the state and federal agencies. The state says the process for getting the necessary waivers and expansion of the Medicaid program was too convoluted and kept shifting. The Feds say the state just kept backing out. The state says the Feds didn’t like the expansions “for some reason we could never really identify.” The Feds say the state cited budget constraints for withdrawing the second time. Either way, the result was the same. After six years, lower income women in Indiana still do not have low cost or free birth control.

The Republican State Senator who co-sponsored the legislation, Luke Kenley, said he was unaware the law had not been implemented. “Frankly, I just trusted the administration to follow through on the thing.” It was a bi-partisan bill, co-sponsored by Democratic State Senator Vi Simpson. States that have Medicaid-covered birth control have had reductions in risks to mothers and babies. South Carolina adopted the plan in 1993, concentrating on women who had recently given birth. They have saved an estimated $1.86 million a year ever since. The official line on the program in South Carolina is that it reduces the known risks of pregnancies that are too close together. No one really wants to say that it cuts the number of children on welfare, increases the speed with which mothers get off welfare and improves their chances of being able to complete their education and find jobs. There is a tipping point in the process of welfare-to-work programs where, if a woman has too many children, it costs the state more to subsidize her day care than to keep her on welfare. The lowered risk argument is a valid one, because of increased health care costs for low birth weight or premature babies, a common result of too-close pregnancies. On a similar program, Texas cut the number of repeat pregnancies within 18 months by 11%.

The law in Indiana targeted poor women. This is the group four times as likely to have an unintended pregnancy and three times as likely to have an abortion, according to a 2006 study by the Guttmacher Institute. When the law was passed, women who received Medicaid during their pregnancies lost that coverage two months after giving birth. The only way they could stay on Medicaid was to earn less than $3,383 a year – 77% below the poverty level. The law would have allowed them to remain eligible for free birth control through Medicaid for two years after their baby’s birth.

Indiana’s law, never implemented, expired in January.

Under the Affordable Care Act, which is going to be dissected by the Supreme Court in late March, every state would provide free birth control to any woman who earns up to 133% of the poverty level starting in 2014. It would also provide for vasectomies for qualified men and provide birth control for those women who have never had a child.

Indiana’s legislature approved a measure to implement this portion of the Affordable Care Act early, but the state’s budget constraints may be getting in the way again. Indiana is in worse financial condition that it was six years ago. They have until December 31 to submit their application for the expansion of Medicaid to do this properly this time.

The best way to prevent abortions is to prevent unwanted pregnancies. The best way to control welfare costs is to prevent repeat pregnancies. It’s a no-brainer.