Updated, 4:45 p.m.: This afternoon, officials with the Centers for Medicare and Medicaid Services responded to the Tribune's request for a comment on the state's latest action. "We formally received their transition plan proposal yesterday and are considering the implications of the longer enrollment period. We will be working with the State to reach a mutually agreeable transition plan that complies with the law while protecting beneficiaries," CMS spokesman Alper Ozinal wrote in an e-mailed statement.
Texas health officials have delivered a proposal to the federal government that outlines their plans for transitioning the Women’s Health Program from a program primarily supported by federal funds to one that runs on state money. They want the federal government to keep paying for the Medicaid program through October “to ensure that current and future clients of the program have access to family planning services without disruption.”
In the proposal, state Medicaid director Billy Millwee acknowledged that the state plan differs from the Centers for Medicare and Medicaid Services’ announcement that it would gradually phase out federal funding of the WHP by April 30. Instead, the state wants to assume “full responsibility for the program” on Nov. 1.
Millwee wrote that the revised start date “allows time for (the Health and Human Services Commission) to follow the Texas rule-making process and to conduct robust outreach to clients and providers.”
At a cost of about $40 million to run annually, the five-year old program had been getting 90 percent of its funding from the federal government to pay for family planning services to 130,000 low-income Texas women, including breast and cervical cancer screenings, STD testing and birth control. So far, HHSC reports that the program has saved the government millions of dollars that would have been spent on Medicaid births.
CMS requested the transition plan after it rejected the state’s enforcement of a rule that excludes Planned Parenthood from being part of the program, even though the funding went to Planned Parenthood’s family-planning clinics that do not perform abortions. State officials in the Legislature and Gov. Rick Perry have said their affiliations and willingness to refer patients for abortions are enough to disqualify them from the program.
The transition packet outlines the state’s plan to find new providers to participate in the program. As it stands, about half of the clients in the Women’s Health Program go to a Planned Parenthood clinic in Texas, and the network receives about 40 percent of the program’s reimbursement funding. Planned Parenthood has filed a federal lawsuit against the state, arguing it is being denied its constitutional right to participate in the program.
Under Perry’s directive, health officials say they are executing plans to operate the program without Medicaid funding and will rename it the Texas Women’s Health Program. They plan to house the program under the Department of State Health Services and to “transition the Medicaid program to a program funded exclusively with state general revenue.” Officials have not confirmed where that funding will come from, or whether it will be diverted from other sources. In response to an inquiry from Democratic lawmakers last month, HHSC Commissioner Tom Suehs hinted the state could free up state dollars to fund the Women's Health Program by seeking federal block grants for other programs.
In addition, the state plans to expand the program’s scope of reimbursements services to include paying for treatment of sexually transmitted diseases. The Medicaid Women’s Health Program was intended to provide early detection and diagnoses; women were referred to other medical providers for treatment of their health issues.
Though family-planning providers have expressed confusion and uncertainty over their futures, HHSC officials maintain there will be a “seamless transition for clients and providers.”
The state’s proposal outlines plans to conduct a campaign that will include more robust referral services and outreach via radio, mailings and brochures. The commission plans to expand its call center’s scope of services to help clients find providers.
Without Planned Parenthood clinics in the picture, health officials say it’s their priority to “increase the number of providers accepting and actively serving TWHP clients and retain current providers.