North Texas safety-net providers will be overwhelmed by women formerly served by Planned Parenthood of Greater Texas (PPGT) if the state refuses federal funds for the Women’s Health Program (WHP), according to a George Washington University study.
Researchers say PPGT clinics served nearly 10,200 WHP women in 2010, compared with about 5,700 served by 51 other local clinics. Without these clinics, the caseload at the remaining facilities would increase 178 percent.
Last week, the Texas health and human services commissioner said the state would shut down the program if a court ordered the state to include providers who are tied to groups such as Planned Parenthood. The state handed down rules for WHP that banned relationships with abortion providers. Federal and state funding has long been banned for directly financing abortions.
There are two lawsuits pending. Texas is suing the federal government, and several Planned Parenthood affiliates are suing the state. Gov. Rick Perry said WHP would be funded entirely by state funds. Perry said Planned Parenthood clinics comprised less than 2 percent of WHP providers. However, the study found that those clinics provided care to about half of WHP clients statewide—and nearly two-thirds of those in North Texas.
The WHP serves more than 100,000 low-income women under a Medicaid waiver. The state plans to exclude Planned Parenthood clinics from the program at the end of the month. By doing so, Texas forfeits the 90 percent of the $36 million program’s funds supplied by the federal government. The Centers for Medicare and Medicaid Services determined that the exclusion violated policies that allowed patients to choose their healthcare providers and withdrew its financial support as of Nov. 1. The state intends to take over funding of the program Nov. 1.
WHP was established under the federal Medicaid program to provide preventive care and contraceptive services to low-income women who are not pregnant. Such programs are intended to cut unintended pregnancies, thereby saving on costs for prenatal, delivery post-partum and infant care. Medicaid covers the costs of more than half of the state’s births. A 2011 Guttmacher Institute study found that nearly 3 out of 4 unintended pregnancies in Texas were publicly funded in 2006.Texas has the fourth-highest fertility rate and teen birth rate.
Texas is considered to have the nation’s most prescriptive abortion counseling laws—including a requirement that physicians tell women abortion is linked with breast cancer. This is despite the fact that a group of scientists gathered by the National Cancer Institute in 2003 concluded abortion did not raise the risk of breast cancer. The 2011 legislature passed a law requiring women to get an ultrasound and their doctors to describe the fetus.
Texas abortions have dropped every year since 2008.
Michael Speer, MD, president of the Texas Medical Association (TMA), said he was encouraged by the rule change in what some considered promotion of abortion.
“While TMA is still reviewing the revised rules, physicians are encouraged by the state’s attempt to better define ‘promote’ to specifically exclude ‘non directive counseling.’ It is very important that patients are able to trust that their doctor is giving the best medical advice for them—based on their medical needs and nothing else,” Speer said.
Last year, Planned Parenthood served nearly 2,000 Women’s Health Program patients in Dallas County alone, said PPGT chief executive officer Kenneth Lambrecht. “These efforts to exclude Planned Parenthood health centers will directly impact tens of thousands of patients in the Women’s Health Program who rely on Planned Parenthood for basic health care, including life-saving cancer screenings, birth control, and annual exams,” he said. “Regardless of any politically motivated barriers placed in front of access to low-income women’s health care, Planned Parenthood will be here for our patients.”
Steve Jacob is editor of D Healthcare Daily and author of the new book Health Care in 2020: Where Uncertain Reform, Bad Habits, Too Few Doctors and Skyrocketing Costs Are Taking Us. He can be reached at firstname.lastname@example.org.