Women's Health Care Access in Steady Decline

As expected, the state-funded Texas Women's Health Program – designed to preclude women from obtaining services from Planned Parenthood – has at midyear served significantly fewer women than were served by the previous program, which was funded by the federal government and included Planned Parenthood.

As of June 1, the Health and Human Ser­vices Commission had processed 79,663 claims for family planning and reproductive health services provided under the TWHP – just 77% of the number processed during the first five months of 2012 (and just 71% of the total claims posted for the same time period in 2012), when the program was known as the Women's Health Program.

The WHP was originally conceived as a way to provide basic family planning and health services for women who would not be eligible for subsidized care unless pregnant. Under the old WHP, for every $1 invested by Texas, the feds kicked in $9, saving the state millions each of the five years it was operational. Moreover, the WHP was designed to help reduce the costs associated with Medicaid births in Texas. (More than half of all births in Texas are paid for by Medicaid, costing the state some $2.9 billion in 2009 alone.)

Planned Parenthood was the single largest provider under the original WHP, serving more than 40% of the roughly 130,000 women enrolled in a single month. But as part of the coordinated efforts since 2011 (begun years earlier) to deny Texas women the ability to seek care from PP, conservative Texas lawmakers rewrote rules for the WHP in order to exclude PP. That was accomplished by redefining the term "affiliate": henceforth, all Planned Parenthood family planning clinics would be considered affiliated with clinics that perform abortion – based largely on the fact that they share the same name – though none of the PP clinics that participated in the WHP provide abortion care; and, as a program designed to prevent unwanted pregnancy, the WHP did not cover abortion care.

The change was successful – but violated federal law, and caused the state to lose the 90% federal funding the program had enjoyed. Gov. Rick Perry said the state would create a rebranded Texas WHP, and so it has – but without reaching nearly as many women as did the original program.

The hit from the drastic 2011 family-planning budget cuts combined with the revamping of the TWHP to exclude Planned Parenthood has led to the closure this year of three PP clinics. Meanwhile, according to enrollment numbers for 2013, the number of women participating in the TWHP program has steadily declined each month this year, to a low of 96,686 enrolled and eligible to receive services in August. The number of claims that have been submitted for services rendered has also declined significantly; in April the program posted its highest numbers, with 16,499 – but that was still just 81% of the 20,442 served in 2012.

Sarah Wheat, vice president for community affairs for Planned Parenthood of Greater Texas, which includes Austin's clinics, is not surprised by the data. "To score political points," she said, "Perry dismantled this program and dictated where women could receive their exams and birth control. Texas women lost access to cancer screenings and annual exams, and the taxpayers lost federal funding and savings from this program – that is what happens when politics drives public health."