Indiana fetal-remains law could boost costs for abortions

Planned Parenthood officials expect greater expenses for abortions in Indiana following a U.S. Supreme Court ruling upholding a state law requiring burial or cremation of fetal remains after an abortion.

Abortion opponents cheered the court's decision as "recognizing the dignity of unborn children" even as the justices sidestepped other provisions of the Indiana law that could have blocked some women from undergoing abortions because of fetal gender, race or disability.

Tuesday's ruling could give conservative state legislatures confidence that restrictions may survive court challenges. Several states have passed new bans in recent months in hopes that the Supreme Court will strike down the 1973 Roe v. Wade decision that legalized abortion.

WHAT WILL CLINICS HAVE TO DO?

The law requires the facility performing the abortion to provide for the burial or cremation, but doesn't specify how the remains should be handled before then or what could be done with the cremation ashes. It hasn't taken effect because of court challenges since then-Gov. Mike Pence signed the provision into law in 2016.

Clinics currently can turn over fetal remains to processors who handle disposal of human tissues or other medical material by incineration. It's likely that abortion clinics will have to hire a funeral home or cremation service, said Chris Charbonneau, CEO at Planned Parenthood of Indiana and Kentucky, which operates four of the six licensed abortion clinics in the Indiana.

Planned Parenthood was responsible for 5,551 of the 7,778 abortions performed in Indiana in 2017, according to the latest figures available from the Indiana State Department of Health.

"I think it is deliberately vague, presumably so there can be games of 'gotcha' along the way if you do something differently than what it is someone, somewhere has in mind," Charbonneau said.

Mike Fichter, president of the anti-abortion group Indiana Right to Life, praised the ruling. "Aborted children may no longer be treated as medical waste or garbage," he said.

WHAT ARE THE ADDITIONAL COSTS?

It is unclear how much the new rules will increase abortion costs.

Indiana Solicitor General Thomas Fisher, who was the state's lead attorney defending the law, maintains abortion providers could face minimal expenses for cremations. Charbonneau, however, said Planned Parenthood could face hundreds of dollars in additional expenses, even though they've been less costly in Minnesota where requirements have been in place since the 1990s.

"They were able to secure that at fairly nominal rates of pay, but that is entirely dependent on whether you can find a partner who's willing to do that with you," she said.

Charbonneau anticipates Planned Parenthood absorbing the added cost or conducting fundraising to avoid charging patients more.

"We may have to follow whatever is in the letter of the law, but we don't have to pass it along to the women who would be ill served by all of that," she said.

WHEN WILL LAW TAKE EFFECT?

Fisher said it could be a month or more before the Supreme Court and Chicago-based 7th Circuit Court of Appeals issue orders allowing the state to implement the fetal remains provisions.

The State Department of Health, which oversees abortion clinic regulation, didn't specify how quickly it would act on the court orders.

"After that information is received, ISDH will integrate the law into the existing facility licensing process and advise all affected stakeholders of the new requirements," the agency said in a statement.

WHAT IS THE POSSIBLE NATIONAL IMPACT?

Texas and Louisiana have adopted similar fetal remains laws in recent years, but those have been blocked by federal judges. Texas Attorney General Ken Paxton said after Tuesday's Supreme Court ruling that he looked "forward to demonstrating that Texas' law is constitutional and does not impact the abortion procedure or the availability of abortion in Texas."

The Ohio Senate approved a version in March but the state House hasn't yet acted on it. Ohio is among the states that this spring have enacted measures barring abortion once there's a detectable fetal heartbeat, while Alabama has adopted a law to ban most abortions.

Supreme Court clearance of Indiana's law will embolden other anti-abortion legislatures, said Charbonneau, who also leads Planned Parenthood's Seattle-based affiliate under an alliance announced in February.

"There will be a rush to see who can make more onerous and ridiculous arrangement requirements," she said.