Analysis Law and Policy

In Texas, the Numbers Reveal Just How Dire Things Will Be for Medicaid Patients Without Planned Parenthood

Andrea Grimes

If Texas excludes Planned Parenthood from participating in its new state-funded "Texas Women's Health Program," 1,748 clients in one city alone--Austin--will have to find new health care providers. That means existing providers, some of which currently see just one or two patients a year, will have to take on about 60 new patients each, even as they deal with a 66 percent cut in overall family planning funding.

Last week, I filmed a video report for Rewire in which I examined the claim–made at various times over the past year or so by Governor Rick Perry, the Texas Health and Human Services department, anti-choice lawmakers, and anti-Planned Parenthood activists–that there are plenty of health providers in Texas who can see Women’s Health Program patients should Planned Parenthood be excluded from participating in the program.

What I didn’t get into was just how dire the situation is, numbers-wise. If you haven’t watched the video report, here’s the gist: The State of Texas is launching a totally state-funded Women’s Health Program to in effect replace the existing Medicaid Women’s Health Program. In 2012, more than $33 million was spent to support the Medicaid WHP, 90 percent or $30 million of which has come from the federal government, and the rest, $3.3 million, provided by Texas this year. The new Texas Women’s Health Program will require full funding by the state–an amazing budgetary leap, considering the dire state of Texas finances right now.

But Texas has said it doesn’t want “abortion affiliates” to participate in the program, despite the fact that Planned Parenthood wholly separates its abortion-providing services from all other services, so they’ll scrounge up those tens of millions elsewhere just to prove a point, even if means forcing the tens of thousands of women who currently rely on Planned Parenthood for their WHP care to jump through a series of pointless hoops as they search for new providers.

For now, I’m going to concentrate on Austin and talk about the WHP providers there, specifically, because that’s what I address in the video I made last week. When I used the search function on the Texas Women’s Health Program website, it turned up 181 ostensible providers of WHP services within 30 miles of Austin, which is located in Travis County. Sounds like a big number–sounds like there should be plenty of access to care even if one Planned Parenthood clinic there can’t see patients. But for anyone who wants to stop by online and do a quick check, it is an incredibly deceptive number.

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The state’s search function recommends places like the Austin Endoscopy Clinic, which is great for colonoscopies but not-so-much for pap smears. It also lists places like the Austin Radiological Association. It lists pediatricians. It contains a whopping 92 duplicate entries. I was finally able to whittle the list down to 13 providers that could take on a WHP patient at this time–and remember, Planned Parenthood is still a participant in WHP as of now, because Medicaid funding doesn’t stop until November 1st of this year.

Still: 13 providers versus 14 providers including Planned Parenthood, can’t be all that bad, right? That’s just one little ole’ clinic. 

Well, it’s one little ole’ clinic that served 1,748 patients in 2010, according to the state’s own public health records, available as an addendum to the existing lawsuit between Planned Parenthood and the State of Texas. Taken together, all the other Travis County WHP providers–29 doctors or clinics that could actually see patients, not the labs that are also listed that processed test results–saw 670 patients.

That means that one Planned Parenthood clinic saw over two and a half times the number of patients that 29 other clinics saw in one year. And that’s just in Austin, where health clinics and doctors are numerous and easily accessible, and where we have a number of low-income clinics like Community Care, which between all 11 of its locations saw 127 patients, and the People’s Community Clinic (which saw 318 patients), plus the Austin Regional Clinic (which saw 90 patients). Most locations? Saw just a few clients. When I made my calls last week, the People’s Community Clinic told me they were only taking new teen-aged patients, because they’re already overloaded.

On average, the 29 Travis County providers that saw WHP patients in 2010 will have to take on 60 new patients each, just to make up for the loss of Planned Parenthood after November 1st. That’s in one metropolitan Texas county. The situation in rural areas is sobering: as Carolyn Jones reported recently in the Texas Observer, Texas lawmakers already cut non-WHP family planning funding by two-thirds last year, forcing clinics that might otherwise have been able to see former Planned Parenthood WHP patients to close or to drastically reduce services:

In their zeal to attack Planned Parenthood, politicians designed a funding formula that caused collateral damage. They defunded many other family planning clinics that aren’t connected to Planned Parenthood and don’t offer any abortion services.

In fact, of the more than 60 clinics that have closed across Texas, only 12 were run by Planned Parenthood. Dozens of other clinics unconnected to Planned Parenthood nonetheless lost state funds and have closed, leaving low-income women in large areas of the state without access to contraception.

What’s also a complete travesty is that one of the funding sources that Gov. Rick Perry’s office says Texas will have to fund its new Texas Women’s Health Program is Medicaid, under the expansion of the Affordable Care Act. Only problem is? Rick Perry has also said Texas will refuse to take that expansion.

The fiscal situation in Texas when it comes to low-income people’s access to health care is much more than just dire, really–it’s completely unintelligible. Before it cut family planning spending in 2011, Texas had at least something of a safety net for low-income women seeking reproductive health care without Planned Parenthood. But this year, with Planned Parenthood’s exclusion from the WHP, they picked it apart, thread by thread, and told more and more people they should try to hang on, anyway.

When does the safety net break? We’ll find out sooner rather than later.

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