Tribpedia: Women's Health Program

The Medicaid Women’s Health Program, created by the Texas Legislature during the 2005 session, was implemented in 2007 as a pilot program to reduce Medicaid costs. It provides low-income women with contraception and family-planning services, along with breast, cervical cancer and other basic health screenings.

To qualify, women must be between the ages of 18 and 44, uninsured, and a U.S. Citizen or legal immigrant. Pregnant women are excluded from the program, which serves about 130,000 women. At a cost of about $35 million to run annually, the program has been getting 90 percent of its funding from the federal government.

In 2011, the Texas Health and Human Services Commission reported that the program had so far prevented thousands of unintended pregnancies and saved the state tens of millions of dollars in Medicaid-financed births.

The 2005 measure creating the Women’s Health Program passed largely because of a Senate amendment banning abortion providers and clinics affiliated with them from participating. But the program allowed the participation of Planned Parenthood clinics that did not perform abortions, as state health officials feared they could face lawsuits over the rule’s constitutionality.

During the 2011 legislative session, after getting the legal go-ahead from Texas Attorney General Greg Abbott, Republican lawmakers pushed to implement the ban on so-called “abortion affiliates.” They directed Health and Human Services Commissioner Tom Suehs to draft a rule banning Planned Parenthood and other “affiliates” from the Women’s Health Program — which he did in February.

In March, the federal government countered that a long-standing statute forbids the state from restricting the choice of providers to its clients, and that it could not continue funding the joint state-federal Women’s Health Program.

Texas fought back, insisting that the state should get to choose the program’s health providers. On March 15, Cindy Mann, the director of the federal Centers for Medicare and Medicaid Services (CMS), sent a letter to state leaders saying the federal government would discontinue funding its share of the program, and instructing the state to present a plan to transition services to women.  

The next day, Abbott filed suit against the federal government over the action.

Gov. Rick Perry has said the state will make up the $30 million shortfall and continue services to low-income women on its own. On April 3, Suehs said in a letter to state Democrats that the money might be made up from other federal block grants, but no concrete plan had been proposed.

On April 11, Planned Parenthood branches filed a federal lawsuit to block their exclusion from the program. Less than a week later, Texas formally presented its transition plan to the federal government, requesting an extension of funding through October. The next day, a CMS spokesperson said the proposal was being considered and that they “will be working with the State to reach a mutually agreeable transition plan that complies with the law while protecting beneficiaries."    

Whether remaining non-abortion affiliate providers enrolled in the program can meet the demands without Planned Parenthood is an open question  — in 2010, Planned Parenthood, while representing 2 percent of clinics in the program, provided more than 40 percent of the services.

Images

Standing in one of the six exam rooms, Chief Executive Officer Carolena Cogdill explains the services offered at Haven Health Clinics in downtown Amarillo Monday, Dec. 9, 2013. The clinic provides services for women in the 26 county region of the Texas panhandle.
One of the six exam rooms at Haven Health Clinics in downtown Amarillo Monday, Dec. 9, 2013. The clinic provides services for women in the 26 county region of the Texas panhandle.