Thousands of Low-Income Women Aren't Getting Cancer Screenings or Birth Control Because Texas Banned Planned Parenthood

A new state report confirms what basically everyone who wasn't a die-hard anti-abortion activist or politician predicted a couple of years ago when Texas lawmakers kicked Planned Parenthood out of its widely successful program for giving uninsured, low-income women cancer screenings and birth control.

According to new numbers out of the state Health and Human Services Commission, critics that said the program would serve a lot less women if it shunned Planned Parenthood's family planning clinics (meaning even more women across the state won't get life-saving breast and cervical cancer screenings or birth control) were dead-on right.

HHCS's numbers show that in 2011 more than 200,000 women were enrolled in the state's original Women's Health Program, a Medicaid waiver program that was 90 percent paid for by the feds. But the program got caught in the crossfire as the ideological battle over abortion rights raged in the Lege. Conservatives, indignant that Planned Parenthood's family planning clinics (which don't provide abortions) got state money under WHP, changed the law so that "affiliates" of abortion providers (re: Planned Parenthood) would be banned from the program.

A couple problems with that. First, Planned Parenthood was in fact the dominant provider in the program at the time, serving somewhere around 40 percent of WHP clients. Women's health advocates across the state urged lawmakers to reconsider, fearing existing healthcare providers wouldn't be able to absorb the clients orphaned by the state's Planned Parenthood ban.

And a second problem: the feds repeatedly told Texas that the state couldn't just arbitrarily ban a qualified provider from a Medicaid waiver program, which would be a violation of longstanding Medicaid law.

In the end, Texas chose to forgo millions in federal funding every year -- money slated to serve poor, uninsured Texas women -- and set up its own Texas Women's Health Program (TWHP instead of WHP) that banned Planned Parenthood as a provider.

So how'd that work out, Texas?

Well, the new HHSC report shows that women enrolled in the program dropped from 207,000 to about 188,000, a 9 percent decline in enrollment. Unsurprisingly, the impact was much more pronounced across the state's rural areas. In West Texas and in the Panhandle, enrollment dropped about 40 percent, while enrollment in the Rio Grande Valley dropped about 20 percent. Clients served (the number of women who actually filed claims) dropped 25 percent across the state, from 115,000 in 2011 to 85,619 in 2013.

This doesn't only mean that fewer women are now getting life-saving cancer screenings than under the federally-funded program that included Planned Parenthood clinics. Part of the whole point of this program when it was created by lawmakers in 2005 was to reduce unplanned pregnancies, a cost-saving measure when you consider more than half of all births in this state are covered by Medicaid. These huge enrollment drops would seem to indicate that fewer low-income women now have access to contraception and family planning services in Texas. Which means that in a dark, ironic twist that only the Texas Legislature could dream up, the anti-abortion fervor that led to Planned Parenthood's banishment from the program could actually lead to more unplanned pregnancies, and ultimately more abortions (if women can find a clinic within 150 miles that's still open, that is).

And how does HHSC explain this marked drop in women served by the state's new Planned Parenthood-less system? The report writers are pretty clear on this point: "The reduction in the number of women served is due, in part, to the change in provider base that occurred in January 2012 with the exclusion of abortion providers and affiliates."

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Michael Barajas
Contact: Michael Barajas