Restoring Family Planning Services Through Primary Care

Medical assistant Alesia Bolden checks Nereyda Penaloza's vital signs during a visit to Women's Health at CommUnityCare, a federally qualified health center, in Austin, Texas.
Medical assistant Alesia Bolden checks Nereyda Penaloza's vital signs during a visit to Women's Health at CommUnityCare, a federally qualified health center, in Austin, Texas.

The fight to restore family planning financing that was cut from the Texas budget in the last legislative session has taken a turn toward primary care. Republican state senators have proposed adding $100 million to a state-run primary care program specifically for women’s health services, an effort that would help avoid a political fight over subsidizing specialty family planning clinics.

“It’s a much better way to treat the women because they don’t just have family planning issues,” said Sen. Bob Deuell, R-Greenville, a family physician who has advocated for increasing primary care services for women.

Using taxpayer dollars to finance family planning services has become politically thorny in Texas, largely because of Republican lawmakers’ assertions that the women’s health clinics providing that care were affiliated with abortion providers. In the fiscal crunch of 2011, the Legislature cut the state’s family planning budget by two-thirds, with some lawmakers claiming that they were defunding the “abortion industry.” Researchers at the University of Texas at Austin found that more than 50 family planning clinics closed statewide as a result of lost financing.

Now, amid estimates that the cuts could lead to 24,000 additional births in 2014-15 at a cost to taxpayers of $273 million, lawmakers are seeking a bipartisan solution to restore financing without ruffling feathers.

Several state senators have suggested earmarking $100 million in general revenue  to the Community Primary Care Services Program, to be used for women’s health services. The program contracts community health clinics and nonprofit organizations to perform a range of services for poor Texans who do not qualify for other state health programs. The additional money could increase the number of patients served annually in the program to 234,000 from 64,000 and nearly double the number of participating health care organizations, to 100 from 57, according to the Department of State Health Services.

Health care advocates say the proposal to add state money to a primary care program could broaden the scope of services and range of women eligible for assistance.

“This new way, hopefully, will invest money in infrastructure to rebuild what the unintended consequences — the impact of the cuts — have been,” said José Camacho, executive director of the Texas Association of Community Health Centers. 

But some women’s health advocates are concerned that without modifications to the primary care program, the strategy would divert money for family planning services, like contraception, to health services for older women.

“There’s an advantage to guiding that money to the family planning, that preventive care piece, because that’s where the cost savings occur,” said Janet Realini, leader of the Women’s Healthcare Coalition.

Health care advocates say there are reasons to restore federal family planning financing, rather than putting state dollars into primary care. But that money, which Texas relied on in previous budgets, is no longer a sure thing. Two other organizations, including Planned Parenthood, have submitted bids to receive and distribute the federal family planning dollars in Texas.

“The goal has always been to keep the funds out of the abortion industry,” said Elizabeth Graham, director of Texas Right to Life. She hopes the expanded primary care program will serve a broader population, but qualified her support by saying Texas Right to Life is “still investigating the participating providers to ensure none are affiliated with abortion providers.”

Texas Tribune donors or members may be quoted or mentioned in our stories, or may be the subject of them. For a complete list of contributors, click here.