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Indianapolis Star
21 hours ago
- Health
- Indianapolis Star
Indiana court upholds abortion ban in case asking for more health exceptions. Here's why
The Indiana Court of Appeals upheld the state's near-total abortion ban on Aug. 11, ruling that the 2022 law did not violate the "life, liberty, and the pursuit of happiness" clause of the Indiana Constitution. The decision is the latest blow to efforts by reproductive rights advocates seeking to expand abortion access after the Indiana General Assembly banned it except in the case of rape or incest, lethal fetal anomalies or risk to the health and life of the pregnant person. Under the first exception, abortions must be obtained within 10 weeks after fertilization while physicians can perform abortions for lethal fetal anomalies up to 20 weeks post-fertilization. In his opinion, Judge Paul Mathias wrote that while people have a constitutionally protected right to abortion when their life or health is seriously at risk, Indiana's abortion ban already contains those exceptions. Chief Judge Robert Altice and Judge Mary DeBoer concurred. The plaintiffs, abortion providers including Planned Parenthood, had argued the opposite, claiming there are specific circumstances where pregnancy risks someone's health or life without qualifying as an exception to the law. These included circumstances like health conditions where pregnancy would require pausing treatment to protect the fetus or severe mental illness. The providers also challenged how the law required all abortions to be performed by licensed hospitals or their outpatient surgical centers, which the court similarly rejected. The appeal affirms the trial court's ruling, which did not find a health condition that would justify an abortion under the Indiana Constitution that was prohibited by the abortion ban law. More: Indiana has a near-total abortion ban. But hospitals still performed some in 2024 The decision follows another Indiana Court of Appeals ruling in 2024 that allowed a small group of Hoosiers who do not believe life begins at conception to obtain an abortion, citing the state's religious freedom law. However, that ruling only applied to the plaintiffs and does not extend to every person with that belief. That case has since been granted class-action status and has returned to trial court. This story may be updated.
Boston Globe
5 days ago
- Politics
- Boston Globe
Vice President JD Vance to visit Indiana as Trump pressures GOP states to redistrict
Vance's visit comes after Texas Democrats successfully stalled a vote there this week on a redrawn congressional map, part of a bid to secure five more GOP-leaning congressional seats at the expense of Democrats before the midterms. The White House's goal is to give Republicans an easier path to maintaining control of the House. Get Starting Point A guide through the most important stories of the morning, delivered Monday through Friday. Enter Email Sign Up Indiana is staunchly Republican, but opponents of any redistricting attempt are planning to make their objections known Thursday with protests and a news conference by the two Democratic members of the state's congressional delegation. Advertisement Braun would have to call a special session if he chooses to start the redistricting process, but lawmakers have the sole power to draw up new maps. Braun's office has not responded to multiple emailed requests seeking more details about Vance's visit. Republican U.S. representatives outnumber Democrats in Indiana 7-2, limiting the possibilities of squeezing out another seat. The constitutionality of the move would also almost certainly be challenged in court. Advertisement Indiana lawmakers have been wary of the national spotlight in recent years, especially after a special session in 2022 resulted in lawmakers enacting a strict ban on abortions. Braun is a staunch ally of Trump in a state with a strong base of loyalists to the president. But Indiana is also home to Mike Pence, the former vice president and a past governor whose more measured approach to partisan politics still holds sway among many state lawmakers. The GOP would likely target Indiana's 1st Congressional District, a longtime Democratic stronghold that encompasses Gary and other cities near Chicago in the state's northwest corner. The seat held by third-term Democratic U.S. Rep. Frank Mrvan has been seen as a possible pickup in recent years as manufacturing union jobs have left the area, said Laura Merrifield Wilson, a professor of political science at the University of Indianapolis. Lawmakers in Indiana redrew the borders of the district to be slightly more favorable towards Republicans in the 2022 election, but did not entirely split it up. The new maps were not challenged in court after they were approved in 2021, not even by Democrats and allies who had opposed the changes that also gave a boost to the GOP in the suburbs north of Indianapolis. Mrvan won reelection in 2022 by a respectable margin and easily retained his seat again in 2024. In a statement Tuesday, Mrvan said the Trump administration knows its policies are 'wildly unpopular.' 'They know that their only hope to maintain control is to pressure the Indiana General Assembly to violate the Indiana Constitution and redistrict U.S. House of Representative(s) seats mid-decade,' he added. The more dramatic option would be to zero in on Indiana's 7th Congressional District, composed entirely of Marion County and the Democratic stronghold of Indianapolis. Advertisement Indiana's legislative leaders, House Speaker Todd Huston and Senate President Pro Tem Rodric Bray, held their same positions four years ago when the Legislature finalized the new maps. Both expressed approval of the final product and said the borders fairly reflected the makeup of the state. 'I believe these maps reflect feedback from the public and will serve Hoosiers well for the next decade,' Bray said at the time. Both leaders have been quiet on the possibility of a special session. Bray and Huston's offices did not respond to multiple messages left over the phone and email Wednesday. Republicans hold a supermajority in the Indiana House and Senate, meaning Democrats could not stop a special session by refusing to attend. Julia Vaughn, director of Common Cause Indiana, said a costly redistricting process will not look good for Republicans who tightened the belt on the state budget this past legislative session due to revenue forecasts. Common Cause is one of the leading groups nationally opposing Trump's push to redistrict. 'I don't think there is any way they could rationalize spending taxpayer dollars to come back to Indianapolis to redraw maps that were just drawn four years ago for purely partisan purposes,' Vaughn said.
Indianapolis Star
6 days ago
- Politics
- Indianapolis Star
Reps. Carson, Mrvan slam White House redistricting attempts as their own seats are under threat
Indiana's two Democratic congressmen condemned the Trump administration's mid-decade redistricting efforts, as Vice President JD Vance prepares to talk to state leaders about the potential for redrawing the maps in Indiana. The congressmen, U.S. Rep. André Carson and U.S. Rep. Frank Mrvan, may be targets themselves. Mrvan, whose northwest Indiana district appears to be trending to the right, has already faced well-funded GOP opponents as the national party seeks to flip the district red. In 2024, House Speaker Mike Johnson told IndyStar the seat 'belongs in the Republican column.' Vance is meeting with Gov. Mike Braun and Indiana General Assembly leaders in Indianapolis on Aug. 7, where he's expected to discuss redistricting. But the jury's out on whether Braun, House Speaker Todd Huston and Senate Pro Tempore Rodric Bray will agree, particularly as any redistricting effort would require a special session. Braun has yet to make any commitments. "I'm going to listen and see where they're coming from," Braun told reporters at the Statehouse on Aug. 5. "And again, I'm going to be listening along with the other two leaders in the legislature and everybody's going to probably have a little different point of view." In a statement on Aug. 5, Mrvan called redistricting efforts an attempt to cling to power. 'It's reprehensible to call in the Indiana General Assembly for a special session on redistricting when the communities I represent believe their time would be better spent to discuss initiatives that restore state funds for our local police departments,' he said in the statement. Democrats have held the 1st district seat for nearly a century but faced trouble in 2022 after lines were redrawn. Since then, Mrvan has held onto the seat by a relatively slim margin — winning by almost six percentage points in 2022 and eight percentage points in 2024. Mrvan also called a potential mid-decade redistricting a violation of the Indiana Constitution. It's unclear if the move would in fact be unconstitutional. It is according to a 1995 opinion from the Attorney General's office, but that opinion is not binding. The section of the Indiana Constitution that opinion refers to requires redistricting to be done by state legislators elected during a federal decennial census year — the next of which is 2030. However, it's unclear how that provision applies to congressional districts. Carson told a crowd gathered at the Indianapolis Artsgarden during a 60-year celebration of the Voting Rights Act on Aug. 6 that Trump wants to redraw district lines because he's a 'dictator.' 'Our voting rights are under attack like never before,' Carson said. He also questioned the legality of the efforts, calling the Indiana Constitution 'clear' on when redistricting is done. Unlike Mrvan, Carson represents the bluest district in Indiana. In 2024, he beat his Republican opponent by nearly 30 percentage points. Carson didn't say if he expected his seat to be targeted when asked by IndyStar but said he was in contact with legislators and advocacy groups. 'We're taking a wait-and-see approach,' he said.
Indianapolis Star
6 days ago
- Health
- Indianapolis Star
Rural hospitals are closing. Nurses could help, if Indiana would let them.
Rural hospitals across Indiana expect to face severe financial difficulties after state and federal Medicaid cuts. That's, in part, because it is harder to retain physicians in rural areas, where the population is more dependent on government assistance, suffers from worse health and faces greater barriers to care. State Rep. Cindy Ledbetter, R-Newburgh, has floated an idea to address this problem every year since she joined the Indiana General Assembly. Her latest effort, House Bill 1116, would have allowed advanced practice nurse practitioners like herself to write prescriptions without needing a collaborative practice agreement with a physician. The problem with collaborative practice agreements, Ledbetter told me, is that they require physicians to review at least 5% of the patient care they provide. 'It creates unnecessary barriers for APRNs to care for patients, limits access and increases costs, (because) some physicians charge $500 an hour or more to review these charts and the hospital administrative fees for writing these agreements are very burdensome,' Ledbetter said. 'So if an APRN wanted to open a medical practice in a rural community, and they had the state average of 2,400 patients, that would be a minimum cost of $15,000 a year.' Nurse practitioners often have just as many years of medical training and education as a physician. Nonetheless, Ledbetter's proposal has never received a hearing. Studies show nurse practitioners tend to move into rural and high-need areas when requirements for collaborative practice agreements are removed. This is important. More than 65% of Indiana counties are considered a primary care professional shortage area or contain a shortage population, while all but 10 of Indiana's 92 counties are considered a mental health professional shortage area. More: Trump's tax bill will crush the rural voters who chose him Modifying medical scope of practice is nearly always a controversial topic with lobbyists, even in fields as seemingly mundane as horse dentistry. Gov. Mike Braun, however, has signaled his approval for eliminating unnecessary professional licensing requirements and regulations. The legislature should take this into account and finally acknowledge this very small-government way to address the state's physician shortage. Lobbyists argue that medical professionals with a slightly different type or length of education will perform a health service significantly worse. The underlying motivation to their opposition, however, seems to be job security. 'During a meeting with the members of the Indiana State Medical Association, it was shared that there is concern that if the collaborative agreement is terminated, hospitals may lay off physicians and replace them with advanced practice nurses, and this is not something that's going to occur,' Ledbetter told me. But, she added, "when you interview these individuals about the legislation, they will tell you that they are concerned about policy and safety and that the APRNs do not have as much education as the physicians.' Opinion: Give medical decisions back to patients, doctors There is a great deal of evidence that granting full scope of practice to nurse practitioners does not lower health outcomes. If nurse practitioners can provide similar health care outcomes at a lower cost, there is no reason to overburden them with regulations. Midwives are another type of health care provider required to work under a physician under Indiana law, despite Indiana's relatively high maternal and infant mortality and lack of obstetric care in rural areas. These professionals are generally utilized during home births. Studies have also shown that they have similar health outcomes to hospital births and can increase the accessibility of care in rural areas. These two examples show Indiana has a broader problem of overburdening health care providers that don't have a doctor of medicine degree with costly regulations — possibly because both the House and Senate committees in charge of the state's health care are run by physicians. "Practitioners' scope of practice is just one of several policy tools to improve access," state Rep. Brad Barrett, R-Richmond, chair of the House Public Health Committee, said in a statement. "However, recent studies from the American Medical Association and the Journal of Rural Health show advanced practice registered nurses tend to follow the same geographic distribution patterns as physicians regardless of scope of practice laws, raising doubts about whether changing those laws would actually improve access." Their preferred strategy has long focused on making health care more competitive and transparent in an attempt to make it more affordable, but those reforms also tend to arbitrarily exclude health care providers without an M.D. 'Giving a one-time tax credit to a physician to open a medical practice is not going to provide much change,' Ledbetter said. 'The reason being is that physicians cannot sustain private practices (in rural areas) due to low Medicaid reimbursement rates, rising processing costs and administrative burdens. … Another thing that's frustrating as an APRN is that bill only allowed for the physicians to have those tax credits.' Other reforms seem to directly work against rural providers. 'I think the financial pressures that recent legislation has passed on hospitals are actually causing increased consolidation," Ledbetter added. Perhaps if there were more representation from other types of health care providers in the legislature, there would be greater support for simply eliminating unnecessary regulations to help all medical professionals meet people where they are. Even in places without the difficulties faced by rural communities, physicians are overworked and often forced to spend most of their time on administrative tasks. Nurse practitioners can be vital partners in their efforts to deliver affordable health care, especially in Indiana's rural communities, if the state would just remove the regulations that keep them from efficiently doing their job.
Indianapolis Star
6 days ago
- Politics
- Indianapolis Star
Indiana families benefit from public education, even if they don't use it
In "Indiana school vouchers favor wealthy families over educational freedom," Deputy Opinion Editor Jacob Stewart deserves credit for touching on a fact that our state legislators consistently ignore: school choice vouchers have done little to shift students from public to private schools. His proposed solution, however, uses faulty data to advocate for a poorly conceived plan. First, the state has no data on the number of students who are homeschooled or what kinds of outcomes they achieve. Our legislature could require reporting and testing, which would help avoid kids slipping through the cracks. Opinion: Let Hoosier kids have summer. School shouldn't start in late July. While individual legislators have proposed such requirements, the Indiana General Assembly has demonstrated no interest in taking up the issue. Second, the data Stewart cites about homeschool outcomes is based solely on so-called "research" performed by Brian Ray, which does not compare similar populations of students from homeschool and public school backgrounds. Third, Stewart's proposed solution of providing education savings accounts to all students provides a financial incentive for parents to act against the best interest of their children. In effect, the state would offer a family with three kids approximately $20,000 per year to pull them out of school. While the majority of families would run from such a devil's bargain, some would take the payout while lacking either the ability, resources or intent to provide an adequate education. Hicks: Indiana's college crisis has nothing to do with woke campuses or high costs Indiana is already a low-tax state that gives a half a billion dollars per year to private schools. Meanwhile, public school funding has failed to keep up with inflation, let alone the increased costs associated with items such as insurance, school safety and providing secure IT services. Stewart's column rests on the flawed assumption that only those with kids in public schools benefit from public education. We all benefit from a funded and functional public education system, just as we all benefit from law enforcement, fire departments, roads, parks and other public goods, regardless of the degree to which we personally use them.
