HHSC: New Women's Health Program Has Enough Providers

The Health and Human Services Commission on Monday said a new survey it commissioned shows the Texas Women’s Health Program has a greater capacity to serve impoverished women than its predecessor, a joint state-federal program that ended after the state moved to exclude clinics affiliated with abortion providers. 

The state's enforcement of the so-called Affiliate Ban Rule led the Obama administration to pull a $9-to-$1 federal match for the original Medicaid Women's Health Program on Dec. 31; in all, 51 Planned Parenthood clinics were forced out of the program. Though Planned Parenthood has filed multiple lawsuits challenging the ban, and suggesting the new program, which launched Jan. 1, doesn't have the capacity to keep treating the same number of low-income women, state health officials disagree.  

“We’ve worked hard to add new doctors and clinics to the program all across the state,” HHSC Executive Commissioner Kyle Janek said in a statement, “and we’ll work even harder in the two areas where we’ve identified some concerns.” 

In 2012, the joint state-federal Medicaid Women's Health Program served 110,000 women — 80,127 of whom received services at Planned Parenthood clinics. HHSC's survey found that the providers in the new state-run program, many of them newly recruited, have the capacity to serve 147,513 patients — and that's without Planned Parenthood services.

The state also conducted regional analysis using GIS mapping software to examine the capacity of providers within 30 miles of a Planned Parenthood clinic. According to the report, they found “capacity was especially robust in the Rio Grande Valley, San Antonio, Houston, Austin and Abilene areas,” but that there is greater need in two other areas of the state — San Angelo and Corsicana. 

“Planned Parenthood’s top priority is ensuring women in Texas get the care they need.  That’s why we’re fighting in court to protect health care access," Ken Lambrecht, president and chief executive officer of Planned Parenthood of Greater Texas, said in a statement. "The simple fact is there is not the capacity for other providers to absorb the tens of thousands of our patients statewide who could be left in the cold if these affiliate ban rules are allowed to stand."

A study conducted at George Washington University that was released in October found Planned Parenthood clinics served more than half of the Medicaid Women's Health Program patients in Bexar, Dallas, Hidalgo County, Lubbock and Midland counties. "If their patients must be served by other clinics, the facilities in those areas would need to expand their capacity by two- to five-fold, in order to absorb the patients now being served by Planned Parenthood," according to the report. The researchers conclude that some women may have problems accessing services if Planned Parenthood clinics are excluded from the program, because "there is no evidence that they are prepared to sustain the very large caseload increases that would be required to fill the gaps left after Planned Parenthood affiliates are excluded."

On Friday, a trial will begin in Travis County District Court to evaluate Planned Parenthood’s claim that the state does not have sufficient capacity to serve women in the program without the organization's clinics. Planned Parenthood has consistently argued that patients will be forced to travel greater distances, wait weeks for an available appointment or fail to receive lifesaving services if Planned Parenthood clinics are excluded from the Texas Women’s Health Program.

For its survey, the state contacted 1,948 women's health providers within a 30-mile radius of Planned Parenthood clinics, and received a response from 44 percent of them. In some cases, previous Women's Health Program providers did not respond, and the state relied on the number of low-income clients they served under the program in 2012. 

“We’re just doing the survey to confirm we had the capacity to replace what we lost,” said Rick Allgeyer, HHSC's director of strategic decision support, who led the survey team. He said that once surveyors confirmed a region had sufficient providers to replace the services previously offered by Planned Parenthood clinics, his team moved on to count providers in other regions.  

“I am still concerned and want to see more information on the specifics,” said Rep. Donna Howard, D-Austin, an ardent advocate for state family planning services. She called the survey results “overly optimistic,” noting that there are still problem areas and that the state did not receive a response from the majority of providers. She also pointed out that the state’s Women's Health Program website, which allows clients to search for available providers in their area, contains many duplicates and specialty providers that do not provide basic women’s health services.

Refining the list of providers on the state’s website is “something we’re definitely still working on,” said Stephanie Goodman, an HHSC spokeswoman. She said she was positive that the state’s count of 3,500 current providers in the program excludes duplicates.