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Texas Women's Health Fund In Jeopardy Over Abortion Politics

Mar 02, 2012

This story is part of a reporting partnership that includes KUHF, Kaiser Health News and NPR

Texas is in a stand-off with the federal government over a program that provides contraception and reproductive check-ups for low-income Texas women. A new Texas rule would exclude Planned Parenthood clinics from participating, even though the program has nothing to do with abortion.

In Texas, poor women can’t usually get Medicaid unless they’re already pregnant. So five years ago, Texas partnered with the federal government to create the Women’s Health Program.

Every year the program helps 130,000 Texas women get contraception, and breast and cervical cancer screenings. Stephanie Goodman with the state Department of Health and Human Services explained the rationale for the program: “Because a woman who is pregnant can qualify for Medicaid services at a certain income level, but the woman at the same income level previously couldn’t get family planning services. So we wanted to expand that to those women.”

The program was set up as part of an agreement Texas has with the federal government in its Medicaid program. The Women's Health Program costs about $40 million a year – with the federal government paying for 90 percent of that.

Jonee Longoria of Houston described how she used the program when she went back to school several years ago to get a bachelor’s degree.

“The women’s health program was, I think, a godsend for me,” she said.

Longoria already had one daughter, and she knew that it wasn’t the right time to have another child. But paying for the pill was difficult on her budget. “I have one child living in poverty, I don’t want another one living in poverty," she recalled thinking at the time. 

Longoria got a degree in social work and sociology and now has a full-time job with insurance benefits. "I was able to turn those tables and turn our lives around and that felt great,” Longoria said. “But I know a lot of that was through WHP and not having another unintended, unplanned pregnancy to worry about.”

The program’s fate is unknown now. On March 14, Texas officials will start enforcing a new rule that excludes participating clinics from the Women’s Health Program if they have a relationship with an affiliate organization that provides abortions.

Hospitals are exempted from this rule, but Planned Parenthood is not. The organization treats about 40 percent of the women who get services through the Women’s Health Program.

In Texas, the Planned Parenthood clinics that provide abortions are legally separated from the Planned Parenthood clinics that provide other services like contraception. But they do have an affiliate relationship.

Peter Durkin, the immediate past president of the organization’s Gulf Coast chapter, says the new rule is aimed squarely at Planned Parenthood, even though it’s not mentioned by name in the law.

“It’s always aimed at Planned Parenthood,” Durkin said. “It’s politically motivated and what it’s going to do is hurt women.”

Federal officials have warned that if Texas moves ahead on this, the state could lose access to the program entirely.

“The federal government says, ‘No, you can’t exclude somebody just because you don’t like them. If you’re a willing provider in the Medicaid program you have to be allowed to participate,’” Durkin said.

Federal officials declined to comment but are continuing to talk with Texas about the stand-off.

Longoria says she doesn’t understand how abortion politics could jeopardize a program that doesn’t fund abortions.

“Regardless of how anybody sits on the abortion side — regardless of they agree or don’t agree with it – if you want to stop having so many abortions, then provide better access for women to have health care and access to birth control,” she said.

State officials argue that because Texas funds 10 percent of the program, state rules must be enforced.  Lucy Nashed, a spokeswoman for Gov. Rick Perry, explained the state’s motivation: “I think that you know here in Texas we respect life and we protect life. And any abortion provider or abortion affiliate would be affected by this and that’s the will of the Texas legislature and that’s why we’ve got it in state law.”

If the Women’s Health Program does end, it will be another blow to reproductive health clinics in Texas.

Last summer, legislators decided to redirect $73 million that had funded family planning. They gave the money to other social service agencies.

Everyone is now waiting to see what happens in the next two weeks.  

Family planning advocates say the cuts will result in either more abortions or more unintended pregnancies among women who qualify for Medicaid that eventually get paid for by Texas taxpayers.
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