Tribpedia: Reproductive Health

Women’s reproductive issues in Texas have been much in the news lately, both statewide and nationally. Behind the headlines and the controversies — from the state vs. Planned Parenthood to Planned Parenthood vs. Susan G. Komen for the Cure — are deep-rooted partisan divides, the intersection of faith and policy, even budgetary pressures.

And statistics: According to the 2010 U.S. Census, just over half of Texas’ 25 million residents are female. Texans have a median age of 33.6; only Utah has a younger population. Nearly 1 in 4 Texans lack health insurance, more than any other state. And Texas has the sixth-highest highest poverty rate, a rate that’s even higher among women than among men. Texas is also home to the fourth-highest rate of teenage pregnancies in the country.

Family Planning Cuts
Texas has traditionally taken a very lean approach to spending on social services, but in 2011, faced with a fiscal crisis, the state Legislature slashed spending on health and human services by 17.2 percent. Reproductive health programs were particularly hard hit; lawmakers, in part in an effort to cut state funding for Planned Parenthood, trimmed funding for Family Planning down from $111 million in the 2010-11 biennium down to $37.4 million for the 2012-13 biennium.

Women’s Health Program
They also targeted the joint state-federal Medicaid Women’s Health Program (WHP) — not for cuts, but in an effort to take funding away from Planned Parenthood.

Passed in 2005 and implemented in 2007, the WHP was designed to provide contraception and cancer screenings for low-income women between the ages of 18 and 45. By non-partisan accounts, the WHP had been highly successful, saving the state millions of dollars in Medicaid assistance for unplanned pregnancies. But from the beginning, Republican lawmakers wanted Planned Parenthood — Texas’ single largest provider of family planning services, and the largest provider of abortions — out. In 2011, the Legislature tightened the law in an attempt to exclude Planned Parenthood clinics altogether, on the grounds that Planned Parenthood clinics that don’t provide abortions still qualify as “abortion affiliates.”

In the spring of 2012, the matter came to a head. The federal government, citing the Social Security Act, said that states cannot deny patients the right to choose a qualified provider, i.e. Planned Parenthood. Texas shot back, saying the state has every right to decide who it will permit to offer treatment and services. As it stands now, the federal government has pulled back its funding for the program, Texas Attorney General Greg Abbott has sued the federal government, and Texas has submitted a plan to the federal government to transition to a state-funded WHP.


Abortion
Abortion politics — and the staunchly anti-abortion views of the state’s Republican leaders — lie at the heart of many women’s health debates in Texas. Planned Parenthood in particular represents a flashpoint, igniting passions on both sides of the aisle.

In 2011, state legislators passed an abortion sonogram bill, which requires a doctor to perform a sonogram on a woman at least 24 hours before she has an abortion. During the sonogram, the doctor must describe the fetus and play the heartbeat aloud; the woman can choose whether she wants to see images from the sonogram or listen to the heartbeat. Victims of sexual assault or incest are allowed to opt out of even hearing the description, regardless of whether they've filed a police report. The bill also includes an exception for medical emergencies. Because of difficulties in fulfilling the law’s requirement of finding a heartbeat and describing the fetus, doctors in many cases have to perform transvaginal sonograms.

The law has been challenged in court; a federal appellate court has ruled that Texas can enforce the law pending the lawsuit’s outcome.

Komen v. Planned Parenthood
In early 2012, the Susan G. Komen for the Cure Foundation, the world’s largest organization devoted to the treatment and cure of breast cancer, announced it was pulling the plug on its partnership with Planned Parenthood, which relied on Komen funds to provide cancer screenings across the nation. Komen said it was bound by its own bylaws prohibiting it from funding any organization under investigation; Planned Parenthood is being investigated by U.S. Rep Cliff Stearns, a Florida Republican who claims the organization is using taxpayer dollars to fund abortions. Planned Parenthood has denied the charge, and claimed Komen’s decision was political. Public reaction was swift, with abortion rights advocates and abortion opponents squaring off in a fierce battle that played out in traditional and social media. Within days, Komen backed down, restoring funding to Planned Parenthood, which has provided almost 170,000 clinical breast exams and more than 6,400 mammogram referrals at its clinics over the last five years.

On August 8, 2012, shifts in the top leadership continued, with CEO and founder Nancy Brinker stepping down from the highest post and president Liz Thompson resigning, effective in September, according to a Komen press release. Two board members, Brenda Lauderback and Linda Law, also stepped down.

The fierce backlash against Komen resulted in a surge in donations to Planned Parenthood, and on August 20, 2012, the organization announced it would use that money to provide enhanced breast cancer screening services to 40,000 women in 5 Texas communities.