Obamacare-supporting Planned Parenthood worried Medicaid expansion will break its bank

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The California wing of Planned Parenthood is worried it will be a casualty of Obamacare’s Medicaid expansion, despite its support for the law, California station Capital Public Radio reported.

“Providers are looking at 2014 with a great deal of trepidation,” said Kathy Kneer, CEO of the Planned Parenthood Affiliates of California 501(c)(4). “Our landlord’s not going to take a rate cut, our utilities aren’t going to take rate cuts, our staff are already undercompensated. It’s very difficult. We just have to reduce services.”

In California, Planned Parenthood and similar reproductive clinics have been paid out of the Family Planning Access Care and Treatment Program, or Family PACT. The fund has no cap, and accounts for 60 percent of Planned Parenthood’s income in California, which allows state funding of abortion.

But now up to 84 percent of Planned Parenthood’s customers will be covered by Medicaid, and Planned Parenthood will have to deal with the much lower doctor payment rates that come along with it.

California’s Medicaid reimbursement rates are the third-lowest in the country and were cut 10 percent in January. Forty-three percent of doctors in California didn’t accept Medicaid patients due to the low rates as of September 2013; now that the Medicaid expansion has sparked another rate cut even that number is likely to drop.

Some reproductive clinics are broadening their services in order to cash in for more federal money from the Medicaid expansion, but Planned Parenthood clinics have to resort to other options.

Medicaid funding of abortion is banned in most situations by the federal Hyde Amendment, meaning that Planned Parenthood clinics will take a hit now that a sizable chunk of its customers will be Medicaid patients. Capital Public Radio, noted that Planned Parenthood clinics that perform abortions will instead try to partner with clinics that don’t in order to be paid for referred patients, instead.

While Planned Parenthood appears to have just become aware of the expansion problems, health care clinics in California have been put in a bind for months. One clinic, Eisner Pediatric and & Family Medical Center in Los Angeles made headlines in September when CEO Carl Coan told reporters the low Medi-Cal (California’s Medicaid program) reimbursements made it difficult to hire enough physicians.

“We run a business. A mission drive business, but it’s still a business,” Coan said. “Believe me, this is going to be tough for clinics because we’re still faced with the uninsured that we have to take care of.”

Planned Parenthood clinics across the country have so far received $655,000 in federal grants to serve as health exchange navigators and championed Obamacare as “a historic advance for women’ s health.”

The national Planned Parenthood Federation of America, which counts the California affiliates as a member, even has an “ACA Outreach Deputy Campaign Director.” The position’s description touts the newly available Medicaid coverage itself.

“Under the Affordable Care Act, millions of uninsured women will be newly eligible for Medicaid under the expansion or will qualify for consumer-friendly premium tax credits to help them purchase coverage in the state health insurance exchange established by the ACA,” the ad explains.

Now the abortion and reproductive services provider may have to reduce services in order to keep their budget in line, Kneer said, but didn’t note which services wouldn’t make the cut. Abortions are highly lucrative for the national federation as a whole, however, and it’s unlikely those would be cut while clinics struggle to make ends meet.

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