News Abortion

Texas Legislators to Restore Family Planning Dollars Via Primary Care Program—Will it Work?

Andrea Grimes

Texas legislators, who slashed the state's family planning funds in 2011, have returned with a new biannual budget that returns the money not through traditional providers, but through a new primary care health program.

With the hard-fought passage of the 2014-15 biannual state budget, Texas legislators appear to have learned a lesson from 2011’s family planning slash-and-burn session, which left tens of thousands of Texans without access to the reproductive health care they’d received in previous years and directly caused the closure of 59 family planning clinics in the state.

But whether the new designation of $100 million in health-care funds over the next two years will adequately address the family planning needs of Texans remains to be seen. Instead of funneling the money back to tailored providers of contraception and women’s health screenings, who are equipped to swiftly and efficiently provide reproductive health care, the state is launching a new care delivery program, sending the funds to primary care doctors and federally qualified health centers.

“It’s much more difficult for a comprehensive provider to really have the systems in place to efficiently provide the family planning care that some of the traditional providers have done,” said Dr. Janet Realini, chair of the Texas Women’s Health Care Coalition. But, she told Rewire, “That doesn’t make it impossible, it just makes a little steeper climb.”

Legislators have gone this route in part because they intend to refuse a federal Medicaid expansion, and because the state lost matching federal funds for the Medicaid Women’s Health Program when it barred abortion “affiliates” like Planned Parenthood from providing care under that program in the state.

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“Had we done the Medicaid expansion, we wouldn’t be having this discussion,” Texas Academy of Family Physicians CEO Tom Banning told Rewire. “These patients would have been covered by Medicaid expansion or exchanges.”

The new budget is a conservative work-around aimed at solving one of Texas’ most pressing problems: getting health care to Texas’ uninsured population, the largest by percentage of any state in the country. (Though the executive commissioner of Texas’ Health and Human Services Department does not believe that to be the case.)

“We got back, for the funding, what we lost in the last biennium,” Banning told Rewire, “but I don’t believe we made a substantial jump forward in terms of the growth of our population, to cover more people that are eligible.”

Texas would rather spend its own money, and more of it, on serving the same or a smaller population of people with a less efficient provider system—at least, for now. It may be that in years to come, a primary and preventative-focused care structure can deliver the same family planning care with the same efficiency Texans received in 2011 and before. That’s Dr. Realini’s hope, and she says she’s personally “optimistic.”

“This is an experiment,” she said. “We’ll see how it works.”

In the meantime, low-income Texans will be the state’s guinea pigs while it works out how providers will be reimbursed for services under a new system with four funding streams, up from two funding streams before the 2011 budget cuts: there’s the state’s new Texas Women’s Health Program, its replacement for the federal Medicaid Women’s Health Program, the state’s new primary health-care program, the state’s family planning program, and a federal Title X family planning grant that went not to the state, as it has for 30 years, but to the Women’s Health and Family Planning Association of Texas, a new coalition of 34 women’s health-care providers, including some Planned Parenthood locations.

But what’s frustrating for many reproductive rights activists in the state is that there wasn’t anything broken about Texas’ family planning system in the first place—at least, not to anyone besides conservative lawmakers who believe Planned Parenthood is an abortion mill and so went on a defunding crusade that did little to damage that organization as a whole but did much to close or weaken other family planning providers. Now, the state is solving a problem it not only created, but has exacerbated, over the past two years.

“We had such a huge devastation of the safety net, not just with Planned Parenthood but other family planning clinics, other family planning programs within institutions like the Baylor University Health System and Parkland [hospital in Dallas],” said Realini. “Even when you have other resources that are held by those organizations, with or without that, it’s going to take some time and effort to rebuild that capability. It’s not something you can just instantly turn on and off.”

Tom Banning says he’s optimistic that a new state funding stream to primary care doctors may increase the range of services provided to low-income patients who might otherwise only have received reproductive health care.

“One of the things that the legislature was really thoughtful about was trying to provide a program that was more holistic in nature,” said Banning. He says he’d like to see, going forward, how the state can “build upon” this new program.

“We are a very fiscally conservative state, and there are competing interests for the limited dollars that we’re willing to put into social health programs,” he said. “That’s going to be an ongoing challenge.”

News Politics

Clinton Campaign Announces Tim Kaine as Pick for Vice President

Ally Boguhn

The prospect of Kaine’s selection has been criticized by some progressives due to his stances on issues including abortion as well as bank and trade regulation.

The Clinton campaign announced Friday that Sen. Tim Kaine (R-VA) has been selected to join Hillary Clinton’s ticket as her vice presidential candidate.

“I’m thrilled to announce my running mate, @TimKaine, a man who’s devoted his life to fighting for others,” said Clinton in a tweet.

“.@TimKaine is a relentless optimist who believes no problem is unsolvable if you put in the work to solve it,” she added.

The prospect of Kaine’s selection has been criticized by some progressives due to his stances on issues including abortion as well as bank and trade regulation.

Kaine signed two letters this week calling for the regulations on banks to be eased, according to a Wednesday report published by the Huffington Post, thereby ”setting himself up as a figure willing to do battle with the progressive wing of the party.”

Charles Chamberlain, executive director of the progressive political action committee Democracy for America, told the New York Times that Kaine’s selection “could be disastrous for our efforts to defeat Donald Trump in the fall” given the senator’s apparent support of the Trans-Pacific Partnership (TPP). Just before Clinton’s campaign made the official announcement that Kaine had been selected, the senator praised the TPP during an interview with the Intercept, though he signaled he had ultimately not decided how he would vote on the matter.

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Kaine’s record on reproductive rights has also generated controversy as news began to circulate that he was being considered to join Clinton’s ticket. Though Kaine recently argued in favor of providing Planned Parenthood with access to funding to fight the Zika virus and signed on as a co-sponsor of the Women’s Health Protection Act—which would prohibit states and the federal government from enacting restrictions on abortion that aren’t applied to comparable medical services—he has also been vocal about his personal opposition to abortion.

In a June interview on NBC’s Meet the Press, Kaine told host Chuck Todd he was “personally” opposed to abortion. He went on, however, to affirm that he still believed “not just as a matter of politics, but even as a matter of morality, that matters about reproduction and intimacy and relationships and contraception are in the personal realm. They’re moral decisions for individuals to make for themselves. And the last thing we need is government intruding into those personal decisions.”

As Rewire has previously reported, though Kaine may have a 100 percent rating for his time in the Senate from Planned Parenthood Action Fund, the campaign website for his 2005 run for governor of Virginia promised he would “work in good faith to reduce abortions” by enforcing Virginia’s “restrictions on abortion and passing an enforceable ban on partial birth abortion that protects the life and health of the mother.”

As governor, Kaine did support some existing restrictions on abortion, including Virginia’s parental consent law and a so-called informed consent law. He also signed a 2009 measure that created “Choose Life” license plates in the state, and gave a percentage of the proceeds to a crisis pregnancy network.

Regardless of Clinton’s vice president pick, the “center of gravity in the Democratic Party has shifted in a bold, populist, progressive direction,” said Stephanie Taylor, co-founder of the Progressive Change Campaign Committee, in an emailed statement. “It’s now more important than ever that Hillary Clinton run an aggressive campaign on core economic ideas like expanding Social Security, debt-free college, Wall Street reform, and yes, stopping the TPP. It’s the best way to unite the Democratic Party, and stop Republicans from winning over swing voters on bread-and-butter issues.”

News Abortion

Parental Notification Law Struck Down in Alaska

Michelle D. Anderson

"The reality is that some young women face desperate circumstances and potentially violent consequences if they are forced to bring their parents into their reproductive health decisions," said Janet Crepps, senior counsel at the Center for Reproductive Rights. "This law would have deprived these vulnerable women of their constitutional rights and put them at risk of serious harm."

The Alaska Supreme Court has struck down a state law requiring physicians to give the parents, guardians, or custodians of teenage minors a two-day notice before performing an abortion.

The court ruled that the parental notification law, which applies to teenagers younger than 18, violated the Alaska Constitution’s equal protection guarantee and could not be enforced.

The ruling stems from an Anchorage Superior Court decision that involved the case of Planned Parenthood of the Great Northwest and the Hawaiian Islands and physicians Dr. Jan Whitefield and Dr. Susan Lemagie against the State of Alaska and the notification law’s sponsors.

In the lower court ruling, a judge denied Planned Parenthood’s requested preliminary injunction against the law as a whole and went on to uphold the majority of the notification law.

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Planned Parenthood and the physicians had appealed that superior court ruling and asked for a reversal on both equal protection and privacy grounds.

Meanwhile, the State of Alaska and the notification law’s sponsors appealed the court’s decision to strike some of its provisions and the court’s ruling.

The notification law came about after an initiative approved by voters in August 2010. The law applied to “unemancipated, unmarried minors” younger than 18 seeking to terminate a pregnancy and only makes exceptions in documented cases of abuse and medical emergencies, such as one in which the pregnant person’s life is in danger.

Justice Daniel E. Winfree wrote in the majority opinion that the anti-choice law created “considerable tension between a minor’s fundamental privacy right to reproductive choice and how the State may advance its compelling interests.”

He said the law was discriminatory and that it could unjustifiably burden “the fundamental privacy rights only of minors seeking pregnancy termination, rather than [equally] to all pregnant minors.”

Chief Justice Craig Stowers dissented, arguing that the majority’s opinion “unjustifiably” departed from the Alaska Supreme Court’s prior approval of parental notification.

Stowers said the opinion “misapplies our equal protection case law by comparing two groups that are not similarly situated, and fails to consider how other states have handled similar questions related to parental notification laws.”

Center for Reproductive Rights (CRR) officials praised the court’s ruling, saying that Alaska’s vulnerable teenagers will now be relieved of additional burdensome hurdles in accessing abortion care. Attorneys from the American Civil Liberties Union, CRR, and Planned Parenthood represented plaintiffs in the case.

Janet Crepps, senior counsel at CRR, said in a statement that the “decision provides important protection to the safety and well-being of young women who need to end a pregnancy.”

“The reality is that some young women face desperate circumstances and potentially violent consequences if they are forced to bring their parents into their reproductive health decisions. This law would have deprived these vulnerable women of their constitutional rights and put them at risk of serious harm,” Crepps said.

CRR officials also noted that most young women seeking abortion care involve a parent, but some do not because they live an abusive or unsafe home.

The American Medical Association, the American College of Obstetricians and Gynecologists, and the Society for Adolescent Medicine have said minors’ access to confidential reproductive health services should be protected, according to CRR.