So, it looks like Texas is at it again – policymakers are seeking to restrict women’s access to vital family planning providers. For years, Texas has run a state family planning program that excludes vital, trusted reproductive health care providers like Planned Parenthood to further its anti-abortion political agenda. Planned Parenthood has long been the target of anti-abortion politicians seeking to bar it from receiving federal funds even though the harmful Hyde Amendment already prohibits the use of Medicaid funds for abortion. For politicians—it’s about punishing Planned Parenthood and other trusted reproductive health providers. For the women impacted—it’s a loss of access to vital health care. And the consequences are not theoretical—research shows that as a result of excluding family planning providers like Planned Parenthood, health outcomes for women in Texas have worsened.
And, a few years ago, Texas sought federal funds to support its discriminatory state program. The Obama Administration – rightfully – told them no. The Obama Administration noted that, per federal law, states may not target “disfavored providers” simply because they offer a “full range of legally permissible” reproductive health care.
But now, Texas is trying again to get federal money to back its discriminatory state program and hoping to get a different answer under the Trump Administration—which has been hostile to women’s health and to women’s health care providers like Planned Parenthood.
In search of federal funds for its program, Texas recently applied for what’s called an 1115 Medicaid waiver. Medicaid 1115 waivers are reserved for innovative, new, experimental programs that expand access to services. But, there is nothing new about Texas’ program and, instead of expanding women’s access to family planning, it does the exact opposite. Texas’ program has proven to restrict and diminish access to family planning services for women who need it the most. And by excluding Planned Parenthood providers from the program, Texas deprives women who rely on Planned Parenthood providers from accessing their trusted source of family planning care—which directly contradicts a cornerstone of federal law that protects patients’ choice of a preferred family planning provider.
If excluding trusted providers like Planned Parenthood isn’t enough of a barrier, Texas also wants to create another barrier for minors seeking family planning services. Texas wants to use federal money to force minors to get their parent’s permission to access reproductive health services. This is despite research showing that this would devastate young people’s access to family planning. According to research, of the 40% of adolescents under 18 who do not tell their parents about reproductive health care visits, 70% indicate they would not seek care if their parents would be informed of the visits.
Now, Texas is asking the federal government to foot the bill for its program, but Texas women are really the ones who will bear the price of this discriminatory program. And they have paid the price in worsened health outcomes.
Since Texas began its state-run discriminatory family planning program, women’s health outcomes have worsened:
- One-quarter of all publically funded family planning health centers in the state have been forced to close. Of the health centers remaining open, 52% of centers focused on reproductive health reduced their hours. These closures put a particularly heavy burden on women in rural areas, because closures drastically increase travel time and transportation costs.
- Today, publicly funded health centers in the state only meet 10% of the need for family planning services.
- Contraceptive method prescriptions declined 41% from 2011 to 2015, and, for women on Medicaid, there was a 35% decline in using the most effective method of contraception.
- By 2016, 26% of Texas women who the state enrolled in the program had not received health care services from a participating provider, up from only 10% in 2011.
- Over four years, the state saw an increase in the maternal mortality rate, with pregnancy-related deaths being even higher among women of color.
- More than half of women in Texas report experiencing at least one barrier accessing reproductive health care, and more than one-third report two or more barriers.
We can’t stand by and let Texas continue to make women bear the burden of its extreme political agenda. And federal funds should never be used to foot the bill for discriminatory action. If the federal government changes course and approves Texas’ waiver, it will set a dangerous precedent that will hurt women’s health outcomes—this is a price that women simply cannot afford to pay.