Is Indiana's abortion clinic law fair?

Should a clinic that doesn't provide abortion procedures — but prescribes an abortion pill — be required to follow the same regulations as those where surgical abortions are performed?

Or are such regulations a way to single out Planned Parenthood's facilities and ultimately prevent a woman's access to an abortion?

Such questions are at the center of a lawsuit challenging an Indiana law opponents say is aimed at shutting down a Planned Parenthood health clinic in Lafayette, the only facility in the state that offers only nonsurgical abortion procedures through the prescription of an abortion pill.

Attorneys for both sides argued their cases Thursday in federal district Judge Jane Magnus-Stinson's courtroom in Indianapolis.

The American Civil Liberties Union of Indiana filed the lawsuit on behalf of Planned Parenthood of Indiana and Kentucky, alleging that Senate Enrolled Act 371 is unconstitutional and places an unjustifiable burden on one facility. The legislation, approved in 2013 by large majorities of the Indiana Senate and the House, changed the definition of "abortion clinic" to include facilities that don't perform surgeries but provide the abortion pill mifepristone to terminate a pregnancy.

That means the Lafayette clinic, the only facility affected by the law, needs to follow the same physical requirements as clinics that provide surgical abortion procedures. These include scrub, procedure and recovery rooms. The law doesn't apply to offices of private physicians providing the same medication.

Ken Falk, legal director of the ACLU of Indiana, said the regulations are irrational and would result in unnecessary costs for rooms that will not be used in the first place. The law does not require the Lafayette clinic to have a doctor who can perform surgical abortions, Falk said, yet it demands the facility to have the physical requirements for surgical procedures.

"You'll have a building that is surgically equipped but doesn't provide or doesn't have to provide surgical procedures," Falk said during the hearing. "The state's ground for imposing certain requirements is feeble at best."

He said, for example, if a doctor buys the Lafayette facility, it then would become a physician's clinic that's no longer subject to the same regulations, "but it's still doing the same thing."

"We're talking about an office that is exactly the same," Falk said, adding that it doesn't make sense to "regulate identical offices differently."

The lawsuit, which was filed in August 2013 against the Indiana State Department of Health and the Tippecanoe County prosecutor, is at least the fourth one filed in the past decade in the contentious fight in Indiana over abortion rights and services provided by Planned Parenthood.

Betty Cockrum, president and chief executive officer of Planned Parenthood of Indiana and Kentucky, said the Indiana law is part of a nationwide effort to target abortion facilities.

"Their purpose is to erect barriers that would make it virtually impossible for facilities to provide abortion services," Cockrum said.

She said educating teens about access to birth control should instead be the focus.

"If you want to reduce abortion," Cockrum said, "you do that by reducing unintended pregnancies."

Thomas Fisher, solicitor general for the Office of the Indiana Attorney General which represents the state, said during the hearing that Planned Parenthood has not provided any statistical proof that shows a large number of women will lose access to abortion because of the law.

Fisher said the statute requires the Lafayette facility to be "minimally prepared" in case a woman who was prescribed the abortion pill comes back to the clinic with emergency complications. The facility needs to have a physical setting "that would facilitate what might be needed if a physician decides right then and there" to perform a procedure, Fisher said.

He said the law does not call for "overwhelming reconstruction efforts" and only requires "marginal changes," such as adding a sink.

"That's all this is about," Fisher said.

He added that Planned Parenthood does tell women to come to the clinic right away for any complications.

Falk said there's no evidence that any woman has ever returned to the Lafayette clinic for any complications. Planned Parenthood also said in court documents that the abortion pill is only a miniscule portion of the Lafayette clinic's prescription practices. For the year ending July 1, 2013, 54 women were prescribed mifepristone. Other medications, mostly contraceptives, were prescribed more than 10,000 times during the same time period.

However, the state argued that the "legislature may constitutionally regulate nonsurgical abortion clinics differently from physicians' offices," according to a statement from the attorney general's office.

"The people's elected representatives in the Legislature made a policy decision in 2013 regarding the physical facilities requirements for nonsurgical abortion clinics, and the State contends the Legislature had that policy-making authority," Indiana Attorney General Greg Zoeller said in a statement.

Magnus-Stinson in November issued a preliminary injunction blocking the law from going into effect on Jan. 1. Because the injunction remains in effect, Planned Parenthood has not looked into how much such a renovation would cost, Falk said.

Magnus-Stinson is expected to make a ruling at a later date.

Star reporter Tim Evans contributed to this story.

Contact Star reporter Kristine Guerra at (317) 444-6209. Follow her on Twitter: @kristine_guerra.