The federal Centers for Medicare and Medicaid Services on Monday shot down Texas' request to ban certain family planning providers – namely Planned Parenthood – from its widely successful Women's Health Program, which provides contraception and general reproductive health care, like cervical and breast cancer screenings, to thousands of uninsured Texas women.
In a conference call with reporters Monday, CMS Director Cindy Mann said Texas and CMS have agreed to kick the can down the road for another three months, extending the WHP, initially set to expire at the end of December, through the end of March 2012. But even as CMS hands the WHP a three-month lifeline, Mann made it clear the feds will not re-approve the program unless the state scraps language that bans providers who offer abortions or “affiliate” with abortion providers, a move that clearly targeted Planned Parenthood (See "Texas quietly killing Women's Health Program").
“I want to be very clear: Medicaid does not pay for abortions and will not pay for abortions,” Mann said. “The issue here is not whether Medicaid funding is involved but whether a state can restrict access to a qualified health provider simply because they provide other services that Medicaid does not pay for. . . . The law does not permit this. We indicated to the state today that their proposal violates longstanding federal law.”
How Texas and the feds compromise going forward is unclear, and language out of HHSC doesn't inspire confidence that the two can find common ground, advocates with Planned Parenthood say. CMS this year has already gone to court with the State of Indiana, where lawmakers tried to exclude Planned Parenthood from the Medicaid program. And in an emailed statement Monday, HHSC spokeswoman Stephanie Goodman reiterated that Texas law, reinforced by a State Attorney General opinion this summer, says the state can exclude physicians, clinics and providers from the WHP that "perform elective abortions or are affiliated with abortion providers."
"HHSC will continue to work with CMS to continue this important program and enforce the state’s right to establish provider qualifications for the program that reflect the values of our state," she said.
Planned Parenthood currently provides roughly half of all WHP services statewide. By the state's own count, the WHP helped Texas avoid some 17,000 Medicaid-paid unplanned pregnancies through family planning programs, not abortions, within the first three years of operation, saving Texas $120 million.
"CMS has clearly said where they are on this language, that it doesn't comply with federal law, and it's almost as though Texas is not really paying attention to what CMS is saying," said Yvonne Gutierrez, vice president of public affairs for the Planned Parenthood Trust of South Texas. "Providers in general are really at a standstill until we know how and if this program is going to continue. ... How do they [Texas and CMS] move forward? We don't even know," Gutierrez said.
Naturally, each side is charging the other of playing politics with women's health care in Texas. Said state Rep. Mike Villarreal, D-San Antonio, a Planned Parenthood supporter, on Monday: "Instead of playing politics with women's health, state leaders need to use this time to find a way to continue the critical health services that Texas women rely on."
Gov. Rick Perry's office released its own statement late Monday that read in part:
I am concerned the Obama Administration is playing politics by holding women’s health care hostage because of Texas’ pro-life policies, sacrificing the health of millions of Texas women in the name of their pro-abortion agenda. We are committed to protecting life in Texas, and state law prohibits giving state dollars to abortion providers and affiliates – a fact the Obama Administration ignores. I strongly urge the administration to do the right thing and grant this waiver, so Texas women can access critical preventative health services, including breast and cervical cancer screenings, rather than making them pay the price for its pro-abortion agenda."
-- By Michael Barajas, firstname.lastname@example.org