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State Laws

Indiana


Political Information

Executive (Governor)

Anti-choice

Senate

Anti-choice

House

Anti-choice

Abortion-Care Policies

Abortion Providers

Abortion Providers: Restrictions

Illinois imposes extra restrictions on abortion providers, despite the fact that all health-care providers already must comply with a variety of federal and state regulations governing health, safety, building and fire codes, and zoning requirements.

Restrictions on Where Abortion Services May Be Provided

Illinois places medically unnecessary restrictions on where abortion services may be provided.

Illinois designates “any facility in which a medical or surgical procedure is utilized to terminate a pregnancy,”  regardless of the number of procedures performed and whether the facility is devoted primarily to this purpose, as a “pregnancy termination specialty center”-a type of ambulatory surgical treatment center.  Other non-abortion-related facilities are required to become licensed as ambulatory surgical treatment centers only if they are “devoted primarily” to the provision of surgery.  210 Ill. Comp. Stat. Ann. § 5/3(A) (Enacted 1973; Last Amended 1994).

A “pregnancy termination specialty center” is limited to providing abortion services up to 18 weeks, and must comply with a uniquely imposed licensure scheme that includes a variety of administrative, physical-plant, record-keeping, personnel, and patient-care requirements.  However, when Illinois’ regulations required this classification for facilities that provided even one abortion, a federal court held the regulations unenforceable. Ragsdale v. Turnock, 625 F. Supp 1212 (N.D. Ill. 1985).

After a court held that the regulatory scheme “infring[ed] on the constitutional right of women to have an abortion,” the parties settled the case with an agreement that enjoined enforcement of the more onerous provisions but permitted the state to continue to regulate outpatient abortion clinics in ways that are not medically justified.

Restrictions on Who May Provide Abortion Services

Illinois prohibits certain qualified health-care professionals from providing abortion services.

Only physicians licensed to practice medicine may provide abortion care.  720 Ill. Comp. Stat. Ann. 510/3.1 (Enacted 1979; Last Amended 1989), 720 Ill. Comp. Stat. Ann. 510/2(2) (Enacted 1975; Last Amended 1988).

A court upheld Illinois’ physician-only requirement as applied to a chiropractor.  People v. White, 387 N.E.2d 728 (Ill. App. Ct. 1978), cert. denied, 444 U.S. 1090 (1980).


Abortion Providers: Expanded Access to Non-Surgical Abortion

The Illinois attorney general has issued an opinion concluding that physician assistants and advanced practice nurses may, in accordance with the statutory requirements and conditions governing their practices, provide mifepristone under the supervision of a qualified physician.  Ill. Op. Att’y Gen. No. 09-002 (March 5, 2009).


Abortion Rights

Post-Viability Ban

Indiana’s post-viability abortion restriction states that no abortion may be provided after viability or 20 weeks gestational age, whichever is earlier, unless necessary to prevent a "substantial permanent impairment of the life or physical health" of the woman.  Unless an increased risk to the woman’s life or health would result, the physician must take all reasonable steps to preserve the life and health of the fetus consistent with the procedure used and keeping with good medical practice, and a second physician must attend.  Ind. Code Ann. §§ 16-34-2-1(a)(3) (Enacted 1973; Recodified 1993; Last Amended 2011), 16-34-2-3(b) (Enacted 1973; Recodified 1993; Last Amended 2011).

NARAL Pro-Choice America supports the legal framework established in Roe v. Wade and does not oppose restrictions on post-viability abortions so long as they contain adequate exceptions to protect the woman’s life and health.  NARAL Pro-Choice America opposes Indiana’s post-viability restriction because the health exception is dangerously narrow.  NARAL Pro-Choice America also opposes this law because it is unconstitutional to the extent that it prohibits pre-viability abortion by conflating viability with the 20-week marker.  A state may not prohibit abortion prior to viability, which is that point at which a fetus is capable of "meaningful life" outside of a woman’s body.  Roe v. Wade, 410 U.S. 113, 163 (1973).  Because viability varies with each pregnancy, states may not declare that it occurs at a particular gestational age.  Colautti v. Franklin, 439 U.S. 379, 388-89 (1979).


Abortion Bans Throughout Pregnancy: Ban by Week

Indiana outlaws abortion after 20 weeks without an adequate exception to protect women’s health or for cases in which the pregnancy is the result of rape or incest.  Indiana amended its previous post-viability abortion ban to apply previability. The law now makes abortion after viability or 20 weeks, whichever is earlier, a criminal act, unless necessary to prevent a substantial permanent impairment of the life or physical health of the woman.  Ind. Code Ann. §§ 16-34-2-0.5 (Enacted 2011), 16-34-2-1 to -7 (Enacted 1997).


Abortion Bans Throughout Pregnancy: Procedure Ban

Indiana also has an unconstitutional and unenforceable criminal ban that outlaws abortion procedures provided as early as 12 weeks.  Indiana’s ban is unconstitutional according to the U.S. Supreme Court’s decision in Stenberg v. Carhart.  530 U.S. 914 (2000).  In Stenberg, the court held that a similar ban, which had no exception to protect a woman’s health and was written so broadly as to ban more than one procedure, placed an undue burden on a woman’s right to choose.  Indiana’s unconstitutional and unenforceable ban makes any abortion procedure that falls within a broad definition a felony unless a physician reasonably believes it necessary to preserve the woman’s life and no other medical procedure will suffice.  Ind. Code Ann. §§ 16-18-2-267.5 (Enacted 1997), 16-34-2-1(b) (Original Statute Enacted 1973; Recodified 1993; Relevant Provision Enacted 1997), 16-34-2-7 (Original Statute Enacted 1973; Recodified 1993; Relevant Provision Enacted 1997).

There is also a Federal Abortion Ban, which applies nationwide regardless of state law.  The federal ban prohibits the provision of certain second-trimester abortion procedures and has no exception for a woman’s health.  In April 2007, the U.S. Supreme Court upheld the ban, making it the first time since Roe v. Wade that the court has upheld a ban on a previability abortion procedure.   


Reasons-Based Ban: Fetal Anomaly

Indiana enacted a law that would ban abortion if sought for reasons of fetal anomaly – either diagnosed or a "potential diagnosis." H.B.1337 (2016). The law has been permanently enjoined because it violates a woman’s constitutional right to due process and violates years of court precedent pertaining to restrictions on pre-viability abortion. Planned Parenthood of Indiana and Kentucky v. Indiana State Dept. of Health, 194 F.Supp.3d 818 (June 30, 2016).


Reasons-Based Ban: Race- and/or Sex Selection

Indiana bans abortion if sought for reasons of the race, "color, national origin, ancestry, sex, or diagnosis or potential diagnonsis" of Down syndrome or other disability of the pregnancy. H.B.1337 (2016). The law has been permanently enjoined because this and the law’s other provisions violate a woman’s constitutional right to due process and violates years of court precedent pertaining to restrictions on pre-viability abortion. Planned Parenthood of Indiana and Kentucky v. Indiana State Dept. of Health, 194 F.Supp.3d 818 (June 30, 2016).


Biased Counseling

Biased Counseling

A woman may not obtain an abortion until at least 18 hours after the attending or referring physician, or a physician’s assistant, advanced practice nurse, or midwife tells her orally, in writing, and in person:  (1) the nature of the proposed procedure; (2) objective information of the risks of and alternatives to the procedure, including the risk of infection and hemorrhage, the potential danger to subsequent pregnancy, and the potential danger of infertility; (3) the probable gestational age of the fetus, including an offer to provide a picture or drawing, the dimensions, and relevant information on the potential survival of a fetus at that stage of development; (4) the risks associated with carrying the pregnancy to term; (5) the name of the physician who will provide the abortion; and (6) the availability of ultrasounds and fetal-heart-tone services; (7) that "human physical life begins when a human ovum is fertilized by a human sperm; (8) that "objective scientific information shows that a fetus can feel pain at or before 20 weeks of postfertilization age; (9) the pregnancy of a child under 15 years of age may constitute child abuse under state law if the act is caused by an adult and must be reported to the of child-services department or local law enforcement.

In addition, at least 18 hours prior to an abortion, the woman must receive a state-mandated lecture orally and in writing that includes:  (1) that medical assistance benefits may be available for prenatal care, childbirth, and neonatal care; (2) that the "father" is liable for child support; and (3) that adoption alternatives are available and that the adoptive parents may legally pay the costs of prenatal care, childbirth, and neonatal care; (4) that there are physical risks associated with abortion; and (5) that Indiana has enacted a safe haven law.

Ind. Code Ann. § 16-18-2-69 (Enacted 1995); § 16-34-2-1 (Enacted 1973; Recodified 1993; Last Amended 1997); § 16-34-2-1.1 (Enacted 1995; Last Amended 2011).

Both federal and state courts held that the "in person" requirement, which in effect requires two office visits, is constitutional.  A Woman’s Choice-E. Side Women’s Clinic v. Newman, 305 F.3d 684 (7th Cir. 2002), cert. denied, 537 U.S. 1192 (2003); Clinic for Women v. Brizzi, 837 N.E.2d 973 (Ind. 2005).


Mandatory Delays

Mandatory Delay

Indiana requires a woman seeking an abortion to wait at least 18 hours between the time she receives biased-counseling materials and when she can get the procedure. Ind. Code Ann. § 16-18-2-69 (Enacted 1995); § 16-34-2-1 (Enacted 1973; Recodified 1993; Last Amended 1997); § 16-34-2-1.1 (Enacted 1995; Last Amended 2011).

Both federal and state courts held that the "in person" requirement, which in effect requires two office visits, is constitutional.  A Woman’s Choice-E. Side Women’s Clinic v. Newman, 305 F.3d 684 (7th Cir. 2002), cert. denied, 537 U.S. 1192 (2003); Clinic for Women v. Brizzi, 837 N.E.2d 973 (Ind. 2005).


Insurance Coverage & Abortion

Prohibits Abortion Coverage in the State

Does Indiana prohibit statewide private insurance coverage of abortion services?

Yes.  Private health-insurance plans offered in the state may not include abortion coverage, with exceptions only to save a woman’s life, avert substantial and irreversible impairment of a major bodily function, or if the pregnancy is the result of rape or incest.  Abortion coverage may be obtained through an optional rider for which an additional premium is paid.  However, insurers are not required to offer such riders and there is no evidence that such separate policies exist. (Even if they did exist, offering women the "option" to pay for separate abortion coverage is a false promise because no one plans for an unplanned pregnancy.)  Ind. Code Ann. §27-8-13.4 (Enacted 2014); Ind. Code Ann. §27-13-7-7.5 (Enacted 2014).


Prohibits Abortion Coverage in the Insurance Exchange

Does Indiana expressly prohibit plans in its state exchange from covering abortion services?

Yes.  Health-insurance policies offered in the state health-insurance exchange may not include abortion coverage, with exceptions only to save a woman’s life, avert substantial and irreversible impairment of a major bodily function, or if the pregnancy is the result of rape or incest.  Nothing in the law prohibits the purchase of abortion coverage outside the exchange through an optional rider for which an additional premium is paid.  However, insurers are not required to offer such riders and there is no evidence that such separate policies exist. (Even if they did exist, offering women the "option" to pay for separate abortion coverage is a false promise because no one plans for an unplanned pregnancy.)  Ind. Code Ann. §27-8-33 (1-4) (Enacted 2011).


Low-Income Women & Abortion

Restricts Low-Income Women’s Access to Abortion

Indiana prohibits public funding for abortion for women eligible for state medical assistance for general health care unless necessary to preserve the life of the woman, where rape or incest caused the pregnancy, or if the pregnancy creates a serious risk of substantial and irreversible impairment of a major bodily function.  Ind. Admin. Code tit. 405, r. 5-28-7; Ind. Health Coverage Programs, Ind. Health Coverage Programs Provider Manual, § 8-467 (Jan. 2011) at http://provider.indianamedicaid.com/ihcp/manuals/chapter08.pdf; Humphreys v. Clinic for Women, Inc., 796 N.E.2d 247 (Ind. 2003).

In Humphreys, the Indiana Supreme Court expanded state medical assistance for abortion by holding that the Medicaid program violated the Indiana Constitution to the extent that it denied assistance for abortion to pregnant women at serious risk of substantial and irreversible impairment of a major bodily function.  Humphreys v. Clinic for Women, Inc., 796 N.E.2d 247 (Ind. 2003).  The court found unconstitutional and unenforceable several statutes and regulations that did not include such assistance.  Ind. Code Ann. § 12-15-5-1(17) (Enacted 1990; Recodified 1992), Ind. Code Ann. § 16-34-1-2 (Enacted 1979; Recodified 1993), Ind. Admin. Code tit. 405, r. 5-28-7.


Young Women & Abortion

Parental Consent

Indiana law restricts young women’s access to abortion.

Is the law enforceable?  Partially.  The parental-consent requirement is still enforceable, but a federal court temporarily enjoined some provisions of the law that were added in 2017.  Planned Parenthood of Indiana and Kentucky v. Commissioner, Indiana State Dept. of Health, et al., case1:17-cv-01636-SEB-DML (June 28, 2017).

Who is considered a minor?  A young woman under the age of 18 who is not emancipated.

What is required – parental consent or parental notice?  Consent.

Who must provide consent?  One parent.  If the young woman is in the state’s custody, the state may not consent to an abortion, with only an exception for the life of the woman and a narrow, inadequate health exception.  

Are there other trusted adults who may provide consent instead?  No.

What is the process for obtaining consent?  A young woman may not obtain an abortion unless the attending physician secures written consent of one parent.  

The parent must provide government-issued proof of identification and some evidence that provides an "articulable basis" that the person is the young woman’s parent.  The physician must keep records of these documents for at least seven years, and write an affidavit to include in the young woman’s medical records.  (This identification requirement is temporarily enjoined.)

May the parental mandate be waived if a young woman is a victim of rape or incest?  No.

May the parental mandate be waived if a young woman is a victim of child abuse?  No.

May the parental mandate be waived if a young woman’s health is threatened?  Yes, but only if the attending physician certifies in writing that there is "an emergency need for a medical procedure to be performed to avert the pregnant minor’s death or a substantial and irreversible impairment of a major bodily function of the pregnant minor."

May the parental mandate be waived under any other circumstances?  Yes, the young woman may try to obtain permission from a judge.

If a young woman must obtain permission from a judge, what is the process?  After the woman petitions the court for permission, a judge will hold a hearing to determine if parental notification of her intent to receive abortion care without parental consent is in the young woman’s best interests.  If the court determines that it is not in her best interests, then her lawyer must provide notice to her parents by certified mail or by personal service, and provide documentation to the court of such notice.  This requirement is waived if the court finds that it is in the young woman’s best interest to obtain abortion care without parental notification.  (This parental-notification requirement is temporarily enjoined.)

For the parental-consent requirement, the young woman must secure a court order stating either that she is mature enough to make her own decision or that an abortion is in her best interest.  She must petition a court in the county where she lives or where the abortion care will be provided.

Are there other significant requirements under the law?  No.

Has a court considered the constitutionality of this law?  No.

Other information about the law:  The attending physician may also petition the court for a waiver on behalf of the young woman, if he feels that compliance with the parental-consent requirement would have an adverse effect on her welfare.

A person who knowingly or intentionally assists a young woman in obtaining abortion care without parental consent may be subject to civil liability.  Moreover, a parent may petition a court to enjoin conduct that would violate these requirements and is "reasonably anticipated to occur in the future."

Ind. Code Ann. § 16-34-2-4 (Enacted 1973; Recodified 1993; Last Amended 2017).


Family-Planning Policies

Insurance Coverage & Contraception

No state measure.

Low-Income Women & Contraception

Supports Low-Income Women’s Access to Contraception

Indiana provides increased access to reproductive-health-care services through a State Plan Amendment (SPA) to its Medicaid program. The SPA allows the state to cover family-planning services for women and men with family incomes at or below 146 percent of the federal poverty level who do not qualify for any other category of Medicaid and have not had a sterilization procedure. Additionally, enrollees must be (1) U.S. citizens or persons who meet the state’s defined immigration requirements and (2) Indiana residents.

Beneficiaries of family-planning coverage available through the SPA are not required to pay premiums or co-payments for covered services. Covered services include: all FDA-approved birth-control methods, devices and supplies; a comprehensive reproductive-health history, physical examination, and pap smear; emergency services directly related to the contraceptive method and follow-up; pregnancy testing and counseling; prevention and treatment of sexually transmitted infections; HIV testing and counseling; limited diagnostic services for fertility management; male and female sterilization; reproductive-health education and counseling.

Indiana State Plan Amendment, IN-11-025, at http://www.medicaid.gov/State-resource-center/Medicaid-State-Plan-Amendments/Downloads/IN/IN-11-025-Ltr.pdf; http://www.medicaid.gov/State-resource-center/Medicaid-State-Plan-Amendments/Downloads/IN/IN-11-025-Att.pdf.  Modified income eligibility standard, at http://www.medicaid.gov/State-resource-center/Medicaid-State-Plan-Amendments/Downloads/IN/IN-13-001-MM1.pdf.


Emergency Contraception

No state measure.

Other Important Issues

Clinic Protections

No state measure.

Fake Health Centers

State Funds Crisis Pregnancy Centers

Indiana funds crisis pregnancy centers (CPCs) directly through taxpayer funds. The funding stream is established through a "Pregnancy Support Program," administered by the Family and Social Services Administration, the State Department of Health, and Real Alternatives, Inc. This program is funded by federal funds made available from Title IV-A of the Social Security Act, Block Grants to States for Temporary Assistance for Needy Families. Through September 30, 2016, CPCs are eligible to receive $3.5 million via this funding stream. 470 Ind. Admin. Code 10.3-1-1 (Enacted, 2007; Last Amended, 2013); 42 U.S.C. 601 et seq.


Refusals & Guarantees

Refusals of Medical Care

ABORTION REFUSAL CLAUSE

Indiana allows certain individuals or entities to refuse to provide abortion services.

To whom does the refusal clause apply?  Hospitals, physicians, or hospital or facility employees or staff members.

What does the refusal clause allow?  Allows physicians, hospitals, or facility employees or staff members, who object on ethical, moral, or religious grounds, to refuse to participate in medical procedures that result in abortion.  No person may be required to participate as a condition of training, employment, pay, promotion, or privileges.  A person’s moral beliefs about abortion may not be a basis for discrimination or discipline.  A person may bring a civil action for damages and reinstatement for violation of these provisions.  No private or denominational hospital may be required to permit its facilities to be utilized for the provision of abortion services.

Does the law require the refusing entity to notify the persons affected?  No.

Are there circumstances under which a refusal clause may not be exercised?  No.

Does the law require the refusing individual or entity to provide medically and factually accurate information or provide a referral for abortion services?  No.

Does the law provide a mechanism for women to otherwise obtain specific reproductive-health services, information, or referrals if an individual and/or entity exercises a refusal clause?  No.

Ind. Code Ann. §§ 16-34-1-3 to -7 (Enacted 1973; Recodified 1993).  


Counseling & Referral Bans

Counseling & Referral Ban

The director or employees of the Indiana Office of Women’s Health may not advocate for, promote, or refer to abortion.  The Office of Women’s Health was established to educate the public, to establish priorities for programs, services, and resources, and to serve as a clearinghouse for information about data, services, and programs addressing women’s health issues.  Ind. Code Ann. §§ 16-19-13-1, -2, -4, -5 (Enacted 1999), § 16-19-13-3 (Enacted 1999; Last Amended 2003).


Everyone should be able to decide if, when, how, and with whom they start or grow a family.

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