State health officials will soon have to decide which is more important: Providing health care to poor Texas women or punishing Planned Parenthood?
The answer to that question will determine the fate of the Women’s Health Program, which uses Medicaid money to provide Pap smears, birth control and cancer screenings to tens of thousands of low-income women in Texas each year.
The program has been the center of a yearlong political controversy. During the 2011 session of the Texas Legislature, conservative Republicans attempted to ban Planned Parenthood from receiving money from the Women’s Health Program. They also tried to prevent the lawmakers from renewing the program.
After barely surviving a tumultuous legislative session last year, the Women’s Health Program still wasn’t in the clear—Republican lawmakers had one more chance to remake the program. Attorney General Greg Abbott ruled in early 2011 that the state Health and Human Services Commission (HHSC) could legally exclude certain providers. The AG opinion gave the state agency authority to craft new language that would keep Planned Parenthood health centers from providing Women’s Health Program services because of their affiliation with the organization’s abortion facilities. With this new rule in place, HHSC submitted an application to the federal government in October to renew the Women’s Health Program. But the feds rejected the application in early December because it violated the Social Security Act, according to the Texas Tribune. The feds won’t allow Texas to exclude Planned Parenthood.
“Texas is asking [the federal government] to allow [it] to discriminate against a qualified Medicaid provider for no other reason than we don't like them,” said Fran Hagerty, director of the Texas Women’s Health and Family Planning Association. “You can extrapolate that if the federal government let that happen, what’s to say that other states can’t discriminate?”
The federal government gave the Women’s Health Program a three-month extension so Texas can resubmit an application. That leaves the state with a choice: Allow Planned Parenthood to receive Women’s Health Program funds or lose the program entirely. Stephanie Goodman, spokesperson for HHSC, said the department “continuing to work with [the federal Centers for Medicare and Medicaid Services] on renewal.”
Hagerty said neither she nor any of the family planning providers her organization represents know what HHSC will do next. Will it submit a revised application that allows Planned Parenthood to provide services, or let the program—which has saved millions in unplanned pregnancy and Medicaid-funded birth costs—die altogether at the end of March?
Family planning clinics in Texas are already reeling from the massive budget cuts passed last session, and for some clinics, Women’s Health Program funding is essential for staying open. “There is so little money available that it's not enough to keep anybody thriving,” Hagerty said. “We’ll lose almost everybody [without the Women’s Health Program]. The situation couldn't be any more critical.”
The Women’s Health Program is operating like normal right now—Planned Parenthood and other family planning clinics and health centers are providing services to women. But Hagerty doesn’t see this ending well.
“Where can these negotiations go? Texas is saying they won't back down or modify, fed government won't violate federal law,” she said. “All these years of work to create this program and get it off the ground…it doesn't matter now because it's gotten in the way of people's politics and agendas.”