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Federal Funding to End; State-Only WHP Planned
On March 15, Texas got official word that the federal government will halt federal funding for the Texas Women's Health Program (WHP).
The state's rule excluding Planned Parenthood clinics and other "affiliates" of abortion providers from participating in WHP went into effect on March 14 . The 2011 Texas Legislature barred Planned Parenthood from WHP, but this exclusion is in conflict with longstanding federal statute, which requires that any willing and qualified provider be allowed to participate in Medicaid programs.
Gov. Perry has instructed the Texas Health and Human Services Commission (HHSC) to find the necessary state funds, estimated at $30-35 million, to replace the federal share of the costs of the program. The program will become entirely state-funded and state-run.
Begun in 2007, WHP annually provides preventive care and birth control -- not abortion -- to approximately 130,000 low-income women who would be eligible for Medicaid coverage if they were pregnant. By providing checkups, cancer and other screenings, and contraception, WHP allows women to plan and space their pregnancies. Until this state-federal impasse, the federal government paid 90% of the program's costs, with the state picking up the other 10%. Because prevention costs so much less (about $200 per year) than care for pregnancy, delivery, and infant care (over $11,000), WHP has saved Texas about $10 for every $1 of General Revenue spent.
The March 15 letter from the federal Centers for Medicare and Medicaid (CMS) outlined a 2-step process for the transition to a completely state-funded program. By April 16, Texas must submit for federal approval a plan to transition the program to state funding within 3 months. The letter also allows for a 6-month phase-out period, if there is no state plan.
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Not Enough Providers; Clinics "Frantic"
It is doubtful that Texas providers can fill the Women's Health Program (WHP) gap. Approximately 44% of WHP patients have received their preventive services from Planned Parenthood clinics, and finding preventive care providers for all of these women will be a challenge.
According to the Texas Association of Community Health Centers, the state's "Federally Qualified" Health Centers, such as CentroMed in San Antonio, cannot rapidly absorb the tens of thousands of low-income women needing care.
Few private physicians participate in the program. Many physicians are unaware of the program, but participation is also limited by the small number of services covered and by the relatively low reimbursement rates.
Ironically, many non-Planned Parenthood family planning clinics may no longer be in a position to care for more patients. Clinics around the state cut back staff and hours -- or even closed their doors -- due to the massive budget cuts to the family planning program beginning in September 2011.
Fran Hagerty, CEO of the Women's Health and Family Planning Association of Texas, described the situation for a number of these non-Planned Parenthood clinics she represents as "frantic" at the prospect of losing WHP. After the budget cuts, some providers are barely managing to keep their doors open, depending on reimbursement from the Women's Health Program (WHP).
The prospect of a state-only WHP is also daunting for these clinics. "No one trusts Gov. Perry to find state money to fund them at the same level as the Medicaid Women's Health Program," Hagerty said in a statement, quoted by the Texas Tribune. If the new state-only WHP program turns out to have limited funding or administrative glitches, the fragile safety-net of preventive care providers will be further weakened.
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Reactions: AG Sues; Women ask "Dr. Rick"
The day after Texas received its letter from CMS halting federal WHP funding, Texas Attorney General Greg Abbott filed a lawsuit against the federal government, asserting the state's right to exclude providers such as Planned Parenthood from the Women's Health Program (WHP). However, Cindy Mann, Director of the federal Center for Medicaid and CHIP Services, indicated that Texas left the federal government no choice because the state's ban violates the federal Medicaid statute. An editorial in the San Antonio Express-News decried the lawsuit as political and pointed out that the suit does not address poor women's health needs.
Meanwhile, numerous women have been posting comments on Gov. Rick Perry's Facebook page, asking his advice about reproductive health problems. The posts from women take the governor to task for forcing a showdown with the federal government over funding of WHP. Mocking comments cite Perry's supposed superior knowledge of women's health and ask the governor questions about topics like menstrual periods, vaginal discharge, and birth control. The comments are being removed, but have been covered in the press.
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Save the Date: HFA Meeting April 19
Healthy Futures Alliance (HFA) members and friends are invited to our next meeting, on Thursday, April 19, 11:30 AM to 1:30 PM (location to be announced).
Please join us as we work to address the crisis in women's healthcare access. At the meeting, you will learn about the issues and add your voice to the discussion. This important meeting will help shape HFA's policy and advocacy priorities for the next year.
HFA is a diverse community coalition to reduce teen and unplanned pregnancy in San Antonio. Some HFA members consider themselves pro-life and others would call themselves pro-choice -- but ALL of us are working together on prevention, using evidence-based strategies in ways that fit our community. We envision a community with prepared parents, planned pregnancies, and healthy families. We want every youth to be able to reach their goals and dreams -- and every child to have all he or she needs to thrive.
HFA is an informal coalition. Individuals and organizations are welcome. There are no membership dues or attendance requirements. Please see our website for more information and to join the coalition.
"Like" us on Facebook and follow us on Twitter @HFTexas.
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Healthy Futures of Texas is committed to reducing teen pregnancy rates in San Antonio
by providing evidence-based programs to young people and
by providing workshops that empower parents to communicate with their teens about sex.
We advocate for accurate and effective education and for increased access to health services,
and we're working to create a healthy social norm regarding teen sexuality and parenthood.
Help us reduce teen and unplanned pregnancy in San Antonio!
2300 W. Commerce, Ste. 203
San Antonio, Texas, 78207
210.223.4589
info@healthyfuturestx.org
www.HealthyFuturesTX.org
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