*Editor's note: This story has been updated with comment from state Sen. Charles Schwertner.
Four years after an aggressive legislative effort to keep Planned Parenthood from receiving state dollars for health care for low-income women, the Texas Senate is back at it — this time over funding for breast and cervical cancer screenings.
The proposed Senate budget would change how funding is distributed from the joint federal-state Breast and Cervical Cancer Services program, which provides cancer screenings for uninsured women. The revised system would prioritize funding to state, county and community health clinics, followed by “non-public entities” that provide screenings as part of “comprehensive” primary and preventative care. Clinics like Planned Parenthood, which specialize in family planning, would be the lowest priority for funding.
Planned Parenthood, which currently serves about 10 percent of the women who participate in the program, says the tiered system is just another effort to knock its clinics out of business. While some Planned Parenthood clinics perform abortions, those that receive government funding are already prohibited by law from performing abortions.
But the Senate's chief budget writer, state Sen. Jane Nelson, R-Flower Mound, said the language in the Senate budget is intended to ensure that facilities unaffiliated with abortion providers are funded first.
“There are many members that feel very strongly that the facilities that receive funding should not be facilities for performing abortions, so the answer is, don’t perform abortions and you get the money,” Nelson said Wednesday. “It’s a tiered system. We’re getting the money to those facilities that are delivering services and not performing abortions.”
The Republican-led Legislature slashed the state’s budget for family planning by two-thirds in 2011 in an effort to prevent health providers even loosely affiliated with abortion providers, like Planned Parenthood, from receiving state tax dollars.
The decision to oust Planned Parenthood from the joint state-federal Medicaid Women’s Health Program also cost the state a $9-to-$1 match from the federal government. State health officials restarted the program as the state-financed Texas Women’s Health Program and kept Planned Parenthood from participating.
But some Planned Parenthood affiliates continued to receive funding from the Breast and Cervical Cancer Services program, which is primarily funded by federal money. In fiscal year 2014, funding for the program included $7.8 million in federal funds and $2.4 million in state funds.
Sarah Wheat, a spokeswoman for Planned Parenthood of Greater Texas, said it’s clear the Legislature is targeting the organization again this year.
Of the 203 health centers statewide that participate in the program, 24 of them are Planned Parenthood affiliates, Wheat said.
Wheat said the tiered distribution of funds would have a dire effect in remote corners of the state where Planned Parenthood clinics are the only ones participating in the cancer screening program.
“From where I’m sitting, this really looks like the next effort to target Planned Parenthood," Wheat said. "And yet really what they’re doing is targeting poor and uninsured women."
But state Sen. Charles Schwertner, R-Georgetown, the Senate Health and Human Services Committee chairman, said the tiered funding plan is about properly distributing resources in "the best way to support" the cancer services program.
"We always want to ensure that we have an adequate provider base to serve low-income Texas women who need access to comprehensive women's health services," Schwertner said in a statement. "At the same time, the people of Texas have clearly indicated that they don't want to see their state tax dollars going to abortion providers."
The House's base budget plan, which was released two weeks ago, does not include the tiered funding mechanism.
Disclosure: Planned Parenthood was a corporate sponsor of The Texas Tribune in 2011. A complete list of Texas Tribune donors and sponsors can be viewed here.
This story was produced in partnership with Kaiser Health News, an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente.