New Women's Health Program Rules Adopted

Last week, the Texas Health and Human Services Commission adopted new rules for the Texas Women's Health Program (TWHP). After strong opposition from the Texas Medical Association (TMA) and other physician groups, the proposed "gag order" -- a rule that would have barred a participating provider from discussing abortion with a patient -- was dropped. The new rules allow doctors and other providers to provide non-directive counseling and neutral, factual information (including information about abortion providers).

This change, among others, was hailed by TMA President, Michael Speer, MD, as a significant improvement. "It is very important that patients are able to trust that their doctor is giving the best medical advice for them - based on their medical needs and nothing else," he said.

The rules for the new state-only funded TWHP, which go into effect on November 1, continue to exclude Planned Parenthood clinics or other "affiliates" of abortion providers. Planned Parenthood has sued the state in federal court to block their exclusion from TWHP. However, the revised rules have a new "poison pill" provision that ends the entire program if Planned Parenthood prevails.

Planned Parenthood clinics have provided the care for about half of the program's more than 100,000 patients, and there is widespread concern that other providers will not be able to meet the need. A George Washington University study found that tens of thousands of women would be unable to get care because other providers lack the capacity needed.

Funding for the new state-only TWHP is also a concern. Because it is not consistent with the federal Medicaid statute, excluding Planned Parenthood clinics from the program means loss of the 9-to-1 federal match that provided about $35 million per year.

Members and friends of the Healthy Futures Alliance are concerned about the loss of access to needed preventive healthcare for thousands of low-income Texas women. TWHP provides screening for breast and cervical cancer and other problems, as well as family planning counseling and a birth control method (not abortion). Not having enough active providers -- or losing the entire program -- would mean more unplanned pregnancies with high risks for prematurity; poor child health; abuse and neglect; low educational achievement; and abortion.

    

FP Cuts: Dismantling the Safety Net

The threats to the Women's Health Program come on top of the severe cuts already sustained by Texas' Family Planning program.  As detailed by the Texas Policy Evaluation Project in the New England Journal of Medicine, the two-thirds ($73 million) cut has had rapid and devastating effects on the fragile safety net of women's preventive healthcare providers across the state.  

More than 50 clinics have closed, and an estimated 200,000 women have lost access to subsidized preventive healthcare services.  Although able to stay open, many other clinics have reduced hours, cut staff, and strictly limited access to the most effective methods of birth control.

Texas has a huge need for preventive healthcare for women, including family planning.  One in 3 Texas women of childbearing age is uninsured, more than any other state.  The Department of State Health Services has estimated that statewide, there are 1.4 million women in need of the preventive services provided in the family planning program. 

  

HFA Meeting: Thank you!

Many thanks to all who turned out for Monday's meeting of the Healthy Futures Alliance (HFA).  We had an excellent discussion of the policy issues that HFA will be working on in the 2013 Texas Legislature.  Participants heard an update on women's health issues, and agreed with the Steering Committee that HFA should join the new Texas Women's Healthcare Coalition.  Stay tuned for more information!