Good and Bad News on Family Planning in New Health and Human Services Report

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Ensuring all Texans have access to family planning services so they can plan the timing and size of their families is critical to building equal economic and social opportunity. In addition, family planning helps women prepare for healthy pregnancies, improving the well-being of both women and their babies.

Texas has a large unmet need for affordable family planning services: roughly 1.8 million Texas women need publicly funded family planning, and in 2017, our key family planning programs served 219,400 women.

Texas made several ill-advised and politically motivated decisions that have reduced access to critical services. The family planning safety net in Texas is still diminished and recovering from dramatic budget cuts in 2011 that closed more than 80 clinics; the exclusion of Planned Parenthood, which had been the state’s largest family planning provider; and the constant upheaval of programs.

A new report from the Health and Human Services Commission (HHSC) provides a snapshot of family planning services for 2017. It contains both good and bad news. Here are our key takeaways:

  1. The number of women getting care is up 29 percent from 2016 to 2017. This good news is no surprise. The state has made substantial new investments to drive enrollment: a $5 million marketing campaign in 2016-17, new automatic enrollment into Healthy Texas Women for moms after they give birth and lose pregnancy-related Medicaid, and an additional $50 million from the state starting in the 2016-17 state budget.
  2. Texas still hasn’t repaired the damage it caused in 2011. It appears we still aren’t serving the number of women Texas did back in 2010 and 2011.  The state changed the way it counts the number of women getting services last year, making direct comparisons to 2010-11 impossible, but the state has provided 2016 counts in both the old methodology and the new one.  Assuming that the change in methodology affects patient counts in prior years the same way it affected the 2016 counts, we can see that clients served in 2017 are still down by tens of thousands of women from 2010–even after all of the new investments mentioned above.
  3. Nearly half of all Healthy Texas Women “certified” providers didn’t serve any women in the program in 2017. HHSC often points to its long and growing list of HTW “certified providers” as an indication of access. However, the number of providers on the list is flawed as a tool for gauging capacity because (1) the list itself – on multiple occasions – has been found to be inflated and full of errors, and (2) as the agency’s new report shows, 46 percent of the providers served no women in the program last year.
  4. The report did not include required data that would provide a clearer picture of provider capacity. HHSC Rider 97 in the state budget lays out requirements for this report, including “the total number of unduplicated patients served, detailed by provider.” HHSC’s report does not include the number of clients served for each provider, which would have conveyed more detailed information about the capacity of program providers.

The new report shows that we must maintain a focus on improving Texas family planning access.  While a one-year bump in services is very welcome news, we still have a long way to go to ensure women in need can access contraception and other family planning services. Read more background here.

Stacey Pogue joined the center in 2008. She focuses on health policy issues. Before coming to the center, she did health policy and research work with the Medicaid and CHIP Division of the Health and Human Services Commission and the Texas Department of Insurance. In 2010 and 2011, she was selected to serve as a funded Consumer Representative to the National Association of Insurance Commissioners (NAIC). Pogue earned a Bachelor of Science in Geography, summa cum laude, from Texas A&M University in 1997 and a Master of Public Affairs from the LBJ School of Public Affairs at The University of Texas at Austin in 2005.

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