[r72] A Clere view of the Statehouse: Planned Parenthood facts tell a different story (7/1/2011)

Friday, July 1, 2011

Start Date: 7/1/2011 All Day
End Date: 7/1/2011
Planned Parenthood facts tell a different story

The Fourth of July has passed, but the fireworks aren't over. Fireworks can be entertaining, but they can also be harmful, and such is the case with some of the political fireworks that keep going off.

It's especially dangerous to set off fireworks in an enclosed area, and that's exactly what's happening as the federal debt ceiling closes in. We're on track to max out our national credit card in less than a month. We can't keep borrowing, and it's time for everyone in Washington to put politics aside and get serious about solving the problem.

Closer to home, Indiana's budget is balanced, but the Hoosier political sky is still filled with bursts of light and noise.

There are several controversial legal cases pending. Just last Friday, a lawsuit was filed over the new school voucher program. The Indiana Supreme Court will soon decide whether to reconsider a much-criticized decision regarding unlawful entry by police. Meanwhile, a federal court issued an order to prevent portions of a new state immigration law from going into effect last week. The same federal court also ruled that Indiana could not enforce a measure that prevented Planned Parenthood from receiving Medicaid funding. Medicaid, which is jointly funded by the state and federal governments, provides health care coverage for low-income people.

It turns out the Planned Parenthood explosion was like one of those rockets that makes a lot of noise but isn't nearly as spectacular as the boom suggests.

House Enrolled Act 1210 started out as a bill aimed at decreasing the number of abortions performed in Indiana. I signed on as a co-author. When the bill went to the Senate after passing the House 72-23, it included provisions to prohibit abortion after the earlier of fetal viability or 20 weeks (previous law simply prohibited abortion after viability, which has become earlier and earlier as medical technology has advanced); improve informed consent; require a doctor who performs abortions to have admitting privileges at a hospital in the county where the abortion is performed or a bordering county, or to have an agreement with a doctor who does; and establish a new breast and cervical cancer screening program for women who are not covered by private insurance or Medicaid.

The provision to defund Planned Parenthood was added in the Senate, and the final version of the bill passed the Senate 35-13 and the House 66-32. I voted for the House version and the final version.

It was reported in the media last month that Planned Parenthood was targeting its New Albany clinic for closure because of the loss of Medicaid funding. The New Albany clinic is one of 28 Planned Parenthood clinics in Indiana. Four of the clinics offer abortions; the New Albany clinic is one of the other 24, which provide referrals for abortion but do not perform the procedure on site.

According to the Office of Medicaid Policy and Planning, which is a division of the Indiana Family and Social Services Administration, from July 1 of last year through April 30 of this year, the New Albany Planned Parenthood clinic received $6,732 in Medicaid reimbursement. OMPP estimates $789 of that total was state funding. The rest was federal matching funds. Based on the total figure, the clinic received a monthly average of $673 in Medicaid funding.

For most medical practices, the loss of $673 wouldn't cause the doors to close. And despite a lot of hype to the contrary, it turns out the New Albany clinic is a relatively minor provider of Medicaid-funded care. According to one of the same media reports announcing the likely closure of the New Albany clinic, the clinic had 6,845 visits by 2,741 patients in 2010. During the 10 months included in the OMPP data, the clinic only saw 80 Medicaid patients. In other words, the New Albany clinic saw a lot of patients who had private insurance or paid out of pocket, but very few Medicaid recipients.

I asked OMPP to identify other providers of family planning services in Floyd County and to calculate the Medicaid reimbursement the providers received. The period they analyzed is a month longer than the period they looked at for the New Albany Planned Parenthood clinic (July 1 to May 31, as opposed to July 1 to April 30), and I have adjusted my calculations accordingly.

OMPP identified seven providers other than the New Albany Planned Parenthood clinic that billed for family planning services. During that period, the seven providers received $188,433 in Medicaid reimbursement. That's an average of $17,130 a month in Medicaid-funded family planning services that were provided in Floyd County by providers other than Planned Parenthood - approximately 25 times the amount billed by Planned Parenthood.

The query actually understates the amount of Medicaid-funded family planning services provided in Floyd County because it looked only at billing codes for services that were identified as family planning services. If a woman on Medicaid saw her family physician for an office visit and received a prescription for birth control pills, for example, that wasn't necessarily counted in the data query, as there's no way to tell whether the office visit was for birth control or a sinus infection or something else. It's safe to say that happens a lot.

Based on the data, it's clear that Planned Parenthood provides only a small fraction of the Medicaid-funded family planning services provided in Floyd County. If a Planned Parenthood clinic is necessary in order for poor women to have access to health care, why is there no clinic between New Albany and Evansville? That's a long stretch of road with a lot of poor women - and men - along it. Why is there no clinic in Jeffersonville or Clarksville?

Indiana Attorney General Greg Zoeller has appealed the Planned Parenthood ruling. Watch for more fireworks. In the meantime, we should stay focused on facts.