The federal government's rejection this week of a state request to exclude certain providers — namely Planned Parenthood — from the Medicaid Women's Health Program was regarded as a victory by some family planning advocates and a travesty by others.
Sandie Haverlah, an Austin lobbyist for Planned Parenthood, said it's a great outcome because it buys advocates time and forces the state to re-evaluate its stance on trying to force Planned Parenthood out of business. "It means the state is probably considering their position,” she said.
But Fran Hagerty, chief executive of the Women’s Health and Family Planning Association of Texas, characterized the federal decision — which extends the program for three months while state officials decide whether to back down from their request — as “the ugliest possible scenario.” She fears the state will opt to end the Women’s Health Program rather than allow Planned Parenthood to continue to be part of it, and that 130,000 low-income women may end up losing out on cancer screenings and birth control.
Following legislators' direction last session, Texas' Health and Human Services Commission asked the U.S. Department of Health and Human Services for permission to operate the Women's Health Program without including clinics linked to providers that perform abortions. (No abortions are provided with Medicaid dollars, or through the Women's Health Program.) On Monday, the federal agency said no — and that doing so would violate the Social Security Act. Instead, federal officials offered to extend the existing program through March to buy time to negotiate a renewal agreement with the state.
On Tuesday, state health officials said they would consult with Attorney General Greg Abbott to determine how to proceed. But Gov. Rick Perry doesn't appear to be in a compromising mood. In a statement from the campaign trail, he said Texas is "committed to protecting life in Texas, and state law prohibits giving state dollars to abortion providers and affiliates — a fact the Obama Administration ignores."
If state officials decide to forgo the Women's Health Program in protest, Hagerty said major hospitals like the University of Texas Medical Branch and Parkland in Dallas would be able to maintain some semblance of family planning services, “but nothing like what we have now.” If the program does not extend past March, Hagerty said, community clinics would have to dramatically reduce services, lay off employees or shut down completely.
Perry is "blaming the feds and saying that this money was going to go to abortions. That’s a complete lie," Hagerty said. “This is a federal program, and they have any right to say you have to let every qualified provider participate. You can’t pick and choose who you like and don’t like.”
Nearly 130,000 women a year rely on the Women’s Health Program. About 46 percent of those clients go to Planned Parenthood clinics for nonabortion services like breast and cervical cancer exams, STD testing and birth control. In fiscal year 2010, HHSC reported that Planned Parenthood clinics received 44 percent of the program’s total reimbursements, making it the largest provider of Women’s Health Program services.
State Rep. Garnet Coleman, D-Houston, said the future of the program now rests with HHSC — and by default, with Perry, who appointed the agency's commissioner. He said the Legislature’s “draconian” restrictions against Planned Parenthood “have nothing to do with abortion. It has to do with giving women the right to go where they choose for family planning services.”
But abortion opponents are throwing the blame right back at the federal government. “By threatening to cancel the Women's Health Program in Texas, the Obama Administration is showing it would sooner deny tens of millions of dollars of medical services to low-income women rather than allow the State of Texas to cut off tax funding to Planned Parenthood,” Joe Pojman, the executive director of Texas Alliance for Life, wrote in an email.
State Sen. Robert Deuell, R-Greenville, said there is a quick solution to this entire debate. “The problem could be solved tomorrow if Planned Parenthood just renounces abortions and just does family planning and comprehensive care, which they’re capable of," he said. "Then we could provide a lot of family planning, and there wouldn’t be abortions and this problem would go away.”
Hagerty said family planning in Texas is trapped in a culture war, and that it's getting increasingly hard for providers to remain optimistic. “This is a political battle that we’re going to lose," she said. "There’s no winning here."