By Stacey Pogue
In a standing-room-only auditorium, CPPP staff shared testimony last week on proposed rules that would dramatically reduce access to services in the Texas Medicaid Women’s Health Program.
Texas funds annual check-ups, family planning, and contraceptives for low-income women through two programs – Department of State Health Services family planning and the Medicaid Women’s Health Program. These programs do NOT fund abortion and abortion providers may not participate in these programs. Recent state actions (more here and here) have severely curtailed these vital programs, causing tens of thousands of low-income women in Texas to lose access to check-ups, cancer screenings, and birth control.
Family planning and birth control are central to maintaining the health of women and children and allowing women to plan the timing and size of their families, a critical step to help families escape poverty and join the middle class.
Several women who shared their stories through testimony today credited publicly funded contraception with empowering them to plan the timing of their pregnancies, allowing them to finish school and start careers. Others received life-saving treatment for cervical cancer after their cancer was detected during an annual exam at a publicly funded family planning clinic.
In the latest assault on publicly funded family planning, the state proposed new rules that prevent Planned Parenthood from participation in the program. Planned Parenthood is the largest provider of services in the Women’s Health Program, providing more than 40% of all services. Remaining providers simply would not have the capacity to meet the needs of women formerly served by Planned Parenthood. This is especially true after last session when the Legislature cut 2/3 of the funding for DSHS family planning, leaving the network of safety net family planning providers in Texas is in tatters. More than 60 family planning clinics that served low-income women have closed.
The new rules also contain a “gag rule” that would prevent doctors in WHP from giving any of their pregnant clients complete and objective counseling on all options including abortion and appropriate follow-up and referrals. Amazingly, this gag rule applies to the interactions between doctors and their non-WHP clients for visits that are not publicly funded (WHP has never paid for pregnancy-related options counseling and women lose WHP-eligibility once they become pregnant). The rule requires doctors to forego their medical ethics and ignore standards of care if they want to participate in the Women’s Health Program. Texas medical societies say doctors won’t participate, leaving low-income women with little meaningful access to family planning services.
Reducing access to family planning services and birth control for low-income women is bad policy. It will increase unintended pregnancies, increase Medicaid costs to the state, and increase abortion.