The state may have finally killed its widely successful Women's Health Program today, in the process cutting off thousands of low-income and uninsured Texas women from basic healthcare and family planning services come next month.
In mid-December the federal Centers for Medicare and Medicaid Services shot down Texas' request to ban certain family planning providers – namely Planned Parenthood – from the program. The WHP, a Medicaid-waiver program that provides contraception and general reproductive health care services, like cervical and breast cancer screenings, covered about 180,000 uninsured Texas women in 2010, according to the state's numbers. And by last count, Planned Parenthood served nearly half of all WHP clients.
CMS Director Cindy Mann made it clear in December the feds couldn't re-approve the program unless Texas scrapped proposed language banning providers that “perform elected abortions or are affiliated with abortion providers,” a restriction aimed at blocking money from Planned Parenthood. “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,” Mann said at the time. “The law does not permit this.
[T]heir proposal violates longstanding federal law.”
CMS gave Texas a three-month extension to negotiate and ostensibly draft new language the feds could approve. With the program set to end March 31, it now appears negotiations are over.
With direction from state Attorney General Greg Abbott, Health and Human Services Commissioner Tom Suehs today signed off on the controversial new rule banning Planned Parenthood and other abortion providers from the program – even though the feds have already said they couldn't approve it. State health officials say that by mid-March WHP providers will have to show they meet the new requirement.
Asked if adoption of the new rule effectively ends negotiations with CMS, therefore killing the program, HHSC spokeswoman Stephanie Goodman responded via email, placing blame on the feds. She wrote:
“Federal law gives states the right to set the criteria for Medicaid providers. That's what Texas is doing. We have a state law that our Attorney General says is constitutional, and it bans abortion providers from taking part in the Women's Health Program. We continue to hope that CMS will reverse its position and allow the program to continue.”
Unless there's a last minute agreement, the state's position appears to mark the end of the program, which currently draws down $9 in federal funds for every $1 the state chips in. CMS offered little by way of comment, with spokesman Alper Ozinal saying only, “We are in contact with state officials but can't speculate at this point.”
“This program is going to evaporate March 31, and there's no evidence [Gov. Rick] Perry or anyone else on down took the effort and time to sit down and think, 'How are we going to save this program?'” remarked Jeffrey Hons, president and CEO of the Planned Parenthood Trust of South Texas. “The politicization of this just continues.
We're limping toward the end of a program that helps over 100,000 women in Texas, and the state chooses to make this a political statement about abortion.”
By the state's own count, WHP helped Texas avoid some 17,000 Medicaid-paid unplanned pregnancies through family planning programs, not abortions. The program saved the state $20 million in 2009 alone. And the end of the WHP only further chips away at women's health care coverage in Texas in light of the conservative-led charge to decimate state family planning services last legislative session.
The Lege gutted the state's family planning budget in 2011, cutting overall funding for such programs from $111.5 million down to $37.9 million, ending preventative care and family planning services for an estimated 180,000 low-income Texas women. The Legislative Budget Board has already estimated those cuts alone could lead to an additional 20,500 unplanned pregnancies.
When adding the WHP's pending demise to those cuts already endured at the Lege, state Sen. Leticia Van de Putte, D-San Antonio, insisted Texas' new women's health care landscape is one poised to create more, not less, abortions. “Even though my Republican colleagues' target point was Planned Parenthood and abortions, they're going to achieve the exact opposite,” she said. “We'll have more unplanned, unintended pregnancies, and it's going to make abortion rates go up. ...They've achieved what they supposedly abhor.”
-- By Michael Barajas, firstname.lastname@example.org