The Politics of Prevention is an occasional series on the effects of state policy on women's health services. Participate in our project by sharing your women's health story here.
The closure of nine of 32 family planning clinics in the Rio Grande Valley — a result of the state Legislature's decision to cut family planning financing in 2011 — has compounded the struggles of low-income, Latina women trying to access reproductive health services, according to a report released Tuesday by the Center for Reproductive Rights and the National Latina Institute for Reproductive Health.
“Profound barriers to reproductive health, including cost, lack of transportation, immigration status and lack of accessible clinics, mean that Latinas in Texas are systemically barred from the care they need to live with health and dignity,” Jessica González-Rojas, executive director of the National Latina Institute for Reproductive Health, said in a statement. “These conditions are dangerous to the health of Latinas and immigrant women.”
The Legislature's decision in 2011 to cut two-thirds of the state’s two-year family planning budget — to $37.9 million from $111 million for 2012-13 — has caused 76 medical facilities across the state to close or stop providing family planning services as a result of lost public financing, according to the Texas Policy Evaluation Project (TxPEP), a three-year study at the University of Texas evaluating the impact of the cuts to family planning services.
The enactment of stricter abortion regulation in November — the constitutionality of which is currently being debated in federal courts — has also caused a third of state's nearly 40 licensed abortion facilities, including the only two abortion clinics in the Valley, to stop performing abortions. The Center has provided legal assistance to the abortion providers involved in that lawsuit.
Although the report released Tuesday focuses on the Valley, TxPEP researchers have found women across Texas have lost access to trusted providers, experienced longer wait times for services and paid higher rates for contraception and other health services, as a result of the 2011 cuts to family planning services.
In its 2013 session, the Legislature sought to mitigate the impact of the 2011 cuts with the largest financial package for women’s health services in state history, increasing spending to $214 million in the 2014-15 budget from $109 million. Texas’ 2014-15 budget includes a $100 million expansion of a primary care program to provide services for an additional 170,000 women; $71 million to operate the Texas Women’s Health Program; and $43 million to replace family planning grants that the federal government awarded to another organization to distribute.
The efforts to rebuild access to reproductive health care is slow moving, as the state is still in the process of contracting providers to participate in the expanded primary care program. Texas Women’s Health Program, which replaced the federally-financed Medicaid Women's Health Program in January after the state violated federal rules by ousting Planned Parenthood clinics, has fewer women enrolled and has processed fewer claims so far this year than during the same time period last year.
For their report, the Center and the Institute, both non-profits that advocate for women's reproductive rights, received feedback on the impact of the family planning budget cuts from 188 women in four counties along the South Texas-Mexico border through private interviews and focus groups. A majority of those women were U.S. citizens or legal residents, and 39 percent volunteered information that they were undocumented immigrants from Mexico.
The women’s stories included in the report should be considered individually, as the report states that “we did not conduct a random sampling of women in the Valley nor do we contend that our findings should be generalized to a wider population.”
The lack of access to reproductive health services has created delays in patient care, which compounds Latina women’s health problems, according to the report. It profiles multiple women who could not afford contraception or found lumps in their breasts, but could not access clinics to receive cancer screenings, because they lacked money or transportation.
Rosa, a 32-year old married mother of three, went to a Planned Parenthood clinic in Weslaco to get a lump in her breast checked in 2011, but she was unable to afford the recommended ultrasound, because it cost $500.
“Half a year later I went back in case they had funding again, because my problem was getting worse and I was feeling sick. But it was the same story again, no funding,” Rosa, whose last name was not included, says in the report. She was taken to a hospital six months later, and doctors discovered she had a growing cyst that was affecting an ovary. “If I didn’t have surgery in time they were going to have to remove my entire uterus,” she said.
Rosa received help to pay for the surgery through a county program that offers assistance for certain health procedures, but she has been unable to afford the follow-up visits.