The Morning After Women’s Health Reform

A new state rule that bars Planned Parenthood clinics from being part of the Texas Women's Health Program took effect yesterday. So what does that mean for the program's future?  
Thu March 15, 2012 8:12 pm
Associated Press | Joy Lewis

Wednesday was the dawn of a new age for women’s healthcare in Texas. Under a new state  rule, healthcare providers like Planned Parenthood and other health clinics with abortion ties will be barred from participating in the state's  Women’s Health Program , which provides coverage to around 130,000 low-income Texan women in need of cancer screenings, wellness exams, and contraception.

This all started last legislative session when legislators passed a law that made it illegal for state funds directed to Medicaid to go to any entity or doctor who performs abortions.  Texas Department of Health and Human Services commissioner Tom Suehs signed the rule on February 23, and it took effect Wednesday.

The problem with the new rule is that it's in direct violation of a federal law that mandates that Medicaid programs (like the Women's Health Program) accept any and all qualifying healthcare providers—including Planned Parenthood clinics, which are now exempt from state funding under the new provision, but treat about 44 percent of the state's Women’s Health Program’s patients. 

U.S. Secretary of Health and Human Services Kathleen Sebelius, who was touring Ben Taub hospital in Houston Friday,  confirmed that the federal government would not provide a waiver to Texas to continue its funding of the health organization. This means that the state will lose about ninety percent of the funds that have propped up the program. (It's worth noting that the same Legislature that passed the new law also cut  $74 million  from Texas’ family-planning budget for the two-year period, even though the program’s preventative services  save $10 in general revenue for every $1 spent.)

But last week, Governor Rick Perry said Texas would  continue to fund the Women’s Health Program regardless of the federal government's decision, but he failed to specify where the $35 million needed to run the organization would come from.

As Paul Burka  wrote yesterday:

[F]inding the money is the easy part. The hard part is putting together a program that works.

Start with the obvious problem: Where are the women who were formerly getting services from Planned Parenthood going to go? Federally qualified health centers? They are already stretched thin to provide services to sick people–plus, their resources were diminished by the legislative zest for budget cuts last session, which one health official described to me as “a frat party that got out of control.” Emergency rooms? Their job is to take care of emergencies, not to provide routine gynecological services and contraceptives. (Not to mention that emergency room care is the most expensive care in the system, and the use of emergency rooms for the program amounts to a Perry-imposed property tax increase for taxpayers in local hospital districts.)

The next issue is who will be the providers? A lot of doctors aren’t going to want to perform these services, because they don’t bring in a lot of money.

Finally, the state can’t set up a health care system without a lot of planning. Computer programs will have to be developed to track payments and to take care of billings and potential fraud. You can’t just snap your fingers and develop a new system.

Perry’s camp issued a  statement on Wednesday stating that a majority of the Texas Legislators—19 senators and 77 house members—support his decision to classify women’s healthcare providers within the program, dismissing abortion affiliates from coverage.

Though abortion has fueled the controversy over the program, ironically one qualification of the Women’s Health Program is that participants  cannot be pregnant  when they enroll. And Planned Parenthood clinics that provide abortion services operate apart from other clinics, which means they aren't affected by the cuts because they already receive no money from the state, as  Newsweek previously reported. 

So far,  eleven non-abortion providing Planned Parenthoods have been forced to close their doors because of lack of funding.

The Houston Chronicle  reported that Sebelius said that direct federal funding to Planned Parenthood was being considered. Meanwhile, Houston Democrats, U.S. Representative Sheila Jackson Lee and state representative Garnet Coleman are trying to find a way for local healthcare providers to  bypass the state to receive the federal funding. 

Outside of the feud between the state and federal governments, activists have taken to Texas to advocate for women’s rights, and Planned Parenthood announced the  Don’t Mess With Texas Women  bus tour that visited cities all around the state:

The tour wrapped up at the Capitol on Tuesday, as protestors with signs reading, “Don’t Mess with Texas Women” and “Texas Men for Women’s Rights” rallied in Austin in front of a tour bus that summed up the tour’s message: “Protect Health Care for 130,000 Women.”

Cecile Richards, Planned Parenthood president and daughter of Ann Richards, took aim at the man who now occupies her mother’s former post saying, “This is my message to Governor Perry. Don’t make your political point on the backs of hundreds of thousands of women in the state of Texas.”

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