The Clere Channel spins out. Again.

In his most recent News and Tribune column, State Representative Ed Clere attempts to provide himself political cover for supporting House Enrolled Act 1210, the plan to defund Planned Parenthood via a change to state Medicaid restrictions. As is often the case, Clere admonishes that "we should stay focused on facts" but then only includes a small, cherry-picked sample of them in an attempt to obfuscate rather than educate.

Clere points out that Planned Parenthood in Floyd County receives only $673 a month in Medicaid funding while other clinics providing Medicaid services here receive a comparatively much larger monthly average of $17,130. Via this incomplete logic, we're supposed to believe that defunding Planned Parenthood is of little consequence to Floyd County or the state.

What he conveniently fails to mention, though, is that HEA 1210 puts Indiana at odds with federal Medicaid funding law. As explained in a letter from Center for Medicare and Medicaid Services Administrator Donald Berwick to state officials, as a condition of receiving federal Medicaid funding, "Medicaid programs may not exclude qualified health care providers from providing services that are funded under the program because of the provider's scope of practice...Therefore, we cannot determine that the proposed amendment complies with section 1902(a)(23) of the [Social Security] Act." In other words, non-compliance with federal law could put the entirety of Indiana's federal Medicaid funding at risk.

It is no surprise to legislators like Clere that this is the case. In an April, 2011, Fiscal Impact Statement (PDF), Indiana's Legislative Services Agency informed the legislature that "The Family and Social Services Administration (FSSA) reports that federal law requires state Medicaid plans provide any eligible individual medical assistance and that they can obtain such assistance from any institution, agency, community pharmacy, or person, qualified to perform the service(s) required. This also includes an organization which provides such services, or arranges for their availability, on a prepayment basis. Federal law permits states to define a qualified provider, but requires that this definition is related to a provider’s ability to perform a service and not what services are provided." Further, the LSA predicted the bill would have no fiscal impact on Indiana precisely because federal law would prohibit its implementation.

In 2010, Indiana's federal Medicaid funding amounted to approximately $4.3 billion, roughly two-thirds of the state's $5.9 billion Medicaid budget. The fact is, an overwhelming majority of the state's Medicaid funding has been jeopardized by Clere and other legislators well aware of the risk, not just six or seven hundred dollars a month for Floyd County's Planned Parenthood clinic as Clere's column suggests. If their obstinacy persists, the result could be a drastic cut to service access in Floyd and other counties as federal Medicaid funding would disappear. To use Clere's example, Floyd County's approximate $18,000 per month average, cut by two-thirds, would be reduced to about $6,000 total, a situation replicated all over the state in larger, more populous counties.

So, indeed, let's "stay focused on facts", but all of them.