In 2013, Texas surrendered $35 million in yearly Medicaid funds for cutting Planned Parenthood from its state family planning program. Now, with a leader in the White House who's already signed legislation to defund Planned Parenthood, state officials are asking for it back.
The state health department submitted a Medicaid waiver for public review Tuesday, asking the U.S. Centers for Medicare and Medicaid Services (CMS) to restore the funding it lost under the Obama Administration. While the law that cost them this funding in 2013 remains intact, it seems state officials believe Trump may be more sympathetic to their request.
"There is a new administration, and we're looking at what opportunities may exist for us," said Carrie Williams, a spokeswoman for the state Health and Human Services Commission, in an email to the Current.
If Trump restores these funds, abortion advocates fear it could encourage other states to start slashing Planned Parenthood from their Medicaid programs, knowing that it will no longer cost them federal dollars. According to Yvonne Gutierrez, Executive Director of Planned Parenthood Texas Votes, "Texas has become the model for other red states wanting to restrict abortion."
Texas' state family planning program used to rely on federal Medicaid dollars for about 90 percent of its funding. But when the state decided exclude any providers that "perform or promote" abortions from the program in 2013, the Obama Administration was forced to suspend all federal funds. Federal law requires states to give Medicaid patients the "freedom of choice" when selecting a willing health care provider — and Texas had effectively taken that choice away.
But Texas, set on blocking low-income women from abortion access, decided it didn't need the feds to help fund its program, and created an entirely state-funded program, dubbed Healthy Texas Woman, in its place.
Because of this major funding cut, state family planning clinics were nearly halved, and the number of women submitting Medicaid claims for acting birth control dropped by nearly 36 percent. Researchers at the University of Texas
found that pregnancies increased 27 percent for women who lost access to Planned Parenthood under the new program. The number of women dying during or shortly after childbirth also doubled.
For the 2017 budget year, the Texas Healthy Women program has an average enrollment of 141,000 women
, much less than the 207,041 who were enrolled in the family planning program in 2011, back when it was federally-funded. The state health department blames poor marketing, and has asked the state legislature to help fund awareness campaigns. And now it's asking the White House to bend federal law to help finance its program
Planned Parenthood's Gutierrez said Trump's approval of these once-banned Medicaid funds would likely trigger litigation, since he'd be breaking the CMS policy by allowing states to restrict a Medicaid patients' health care options. He may have to change the law to legally return these funds. But if Trump's past opposition to Planned Parenthood means anything, it may be a fight he's willing to take on.
“There have been many statements out of this administration about its hostility toward Planned Parenthood,” said Elizabeth Nash, a policy analyst at the Guttmacher Institute, an abortion policy research center, in an interview with the New York Times.
“So this move by Texas is really testing all of that.”
While Planned Parenthood Texas won't feel the impact of this decision right away — since its already cut from Healthy Texas Woman funding — Gutierrez said it's the longterm implications that scare her the most.
"Part of my concern is where does this end? If we allow states to limit family planning funds through Medicaid, could they use it to justify defunding LGBT care?" she asked. "Where do we go next?"
The public has until June 12
to comment on the state's proposed waiver to request the Medicaid funding from the feds.