Does the will exist in the Capitol to restore the deep cuts to women’s health from last session? Maybe, if the opinion of a Senate finance committee working group is shared by the rest of the Legislature.
The Legislature slashed two thirds—or $73 million—from the state’s family planning budget during the 2011 session, which Texas Monthly’s Mimi Swartz dubbed “the most aggressively anti-abortion and anti-contraception session in history” in her August 2012 cover story on women’s health. These cuts led to the closure of 53 women’s health clinics, leaving some 147,000 low-income women without care. At the same time, the Legislature also passed a sonogram law and tweaked the rules of the Medicaid Women’s Health Program to exclude Planned Parenthood health clinics, amounting to, in Swartz’s words, “a full-scale assault on the existing system of women’s health care.”
But on Thursday, the Senate finance committee workgroup on Article II, the health care section of the budget, signaled it would like to take things in a different direction this session, allotting an additional $100 million to women’s health care in the next biennium. “It is the desire of the majority of members of this body that there is access to family planning for all,” Senator Jane Nelson (R-Flower Mound), chair of the working group and the Senate Health and Human Services Committee, said in an interview on the Senate floor Wednesday. “I don’t think this is a political fight. We are going to put additional funding in women’s health care.”
This move should be a popular one. A new poll from Texas Freedom Network found that 57 percent said they opposed last session’s deep funding cuts to family planning. The poll, jointly conducted by Chesapeake Beach Consulting and Greenberg Quinlan Rosner Research, Republican and Democratic polling firms respectively, also found that a majority of Texans—68 percent—agree that women of all income levels have access to family planning and birth control. (The results did break down strongly by party, with 95 percent of Democrats saying they favored such access versus 50 percent of Republicans.)
“This poll says that throwing issues of family planning and birth control into the culture wars is a mistake,” TFN president Kathy Miller said at press conference announcing the results of the poll last Tuesday. “In the budgeting process I think legislators would be wise in restoring those cuts. It would help thousands of women and it would barely make a dent in the surplus.”
Dr. Janet Realini, chair of the Texas Women’s Healthcare Coalition, a newly formed non-partisan organization dedicated to “assuring access to preventative healthcare for all Texas women,” said her organization was heartened by the workgroup’s proposition.
“We anticipate that this will go a long way to restoring access for a lot of those 147,000 women who lost access from the budget cuts of 2011,” Realini said in an interview Thursday. “We’re just thrilled with what happened today.” (TWHC counts the Texas Medical Association, the Texas Association of Obstetricians and Gynecologists and the Methodist Healthcare Ministries among its members.)
But, it is worth noting, this $100 million wouldn’t be put back in the same place as the money that was cut: the Senate base budget contains $114 million for women’s health, $43 million of which is directed per year for Family Planning Services and $26 million for Community Primary Care Services. While the $73 million in cuts from last session came out of the family planning bucket, the proposed additional $100 million would go into that second bucket, a program that provides primary and preventative healthcare to low income men and women.
This would mean that much of this care would come via primary physicians, an idea that Senator Bob Deuell (R-Greenville), a member of the Senate Article II workgroup and vice-chair of the Health and Human Services Committee, has long supported. “My goal is that lower income women have access to primary care doctors and comprehensive care,” Deuell said in an interview on the Senate floor Wednesday. Currently, the Community Primary Care Services provides care through 57 primary health contractors, including local health departments, hospitals, and Federally Qualified Health Centers, many of which are already bulging at the seams with patients. (Christine Mann, a spokeswoman for the Texas Department of State Health Services, said that if the program received the funding, the number of providers would be expanded.)
Deuell, a primary care physician, was instrumental in last session’s push to exclude Planned Parenthood’s health clinics from the Women’s Health Program (which ultimately led the federal government to withdraw all $30 million in funding from the program). But he has also long been a supporter of state-funded birth control for poor women, and said Wednesday that he opposed the cuts of last session. “We hope to restore them completely,” he said.
José E. Camacho, executive director of the Texas Association of Community Health Centers, cheered the news, but offered a word of caution: “It’s going to be some time before we can rebuild the infrastructure that we had before last session, but this is certainly a step in the right direction,” he said.
One consequence of the 2011 cuts? Less birth control means more births. As the Texas Tribune’s Emily Ramshaw noted in December, the Health and Human Services Commission has estimated that low-income women will have 23,760 more babies in 2014 and 2015, at a total cost to Medicaid of about $273 million. (Each birth costs an average of $11,000, and Texas Medicaid covers $4,400 of that, so the state is on the hook for around $100 million, according to the Center for Public Policy Priorities.) So the Senate workgroup’s proposed $100 million has the potential to pay for itself. The same goes for spending money on preventative care, such as pap smears and mammograms. “You will save money if you work on the prevention end—and it’s the right thing to do,” Nelson said.