An amendment passed this week amid an 18-hour budget debate in the Texas House of Representatives could provide Texas’ reproductive health watchdogs with data they’ve long clamored for: the number of providers recruited by the state health department to serve low-income Texans in a state-run cancer screenings and contraceptives program.
The amendment, proposed by Rep. Donna Howard (D-Austin), would require state health services to produce a list of Texas Women’s Health Program (TWHP) providers without duplicate entries or “ancillary” providers.
Lawmakers, activists, and journalists have for years disputed claims made by public health bureaucrats and anti-choice lawmakers about the TWHP’s provider list, which they said contained misleading duplications and erroneous listings, perhaps in an effort to make the program appear more robust than it really was, and to downplay the negative consequences of lawmakers’ successful efforts to boot Planned Parenthood from participation in the program.
Anti-choice lawmakers banned Planned Parenthood from the original, mostly federally funded Medicaid Women’s Health Program in 2012, and the State of Texas lost its 9-to-1 funding match because of the state’s refusal to allow low-income Texans to choose to receive care from Planned Parenthood if they so desired.
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The new, entirely state-funded Texas Women’s Health Program, was launched in January 2013.
Since then, representatives for the Texas Health and Human Services Commission (HHSC), which oversees the TWHP, have claimed that the program has actually increased capacity, and that it has thousands of doctors and clinics ready and able to serve TWHP patients. Anti-choice lawmakers have tended to take the department at its word.
Investigations into those claims have shown that HHSC’s TWHP provider database is deeply flawed, prompting HHSC to take down and relaunch its provider list in 2013, and HHSC’s own data has shown, repeatedly, that when anti-choice lawmakers booted Planned Parenthood from providing low-cost reproductive services to Texans, accessible and affordable health care were stripped from thousands of Texans.
Republican lawmakers late in 2013 even hosted a country music fundraiser to drum up money for a new website to promote the TWHP and other state-funded family planning programs; that website was meant to make information about the TWHP, including doctors available to serve its enrollees, easier to access.
That website, HealthyTexasWomen.org, finally launched in November 2014, but a recent investigation by NARAL Pro-Choice Texas appears to show that the TWHP’s provider database—which is supposed to help TWHP enrollees find doctors or clinics—is still experiencing the issues it had at the outset: duplications and erroneous entries that could be misleading or confusing to TWHP patients.
NARAL conducted a 26-county study of listed providers from the TWHP website, and found that just 16.6 percent of the search results turned up a doctor or clinic available to enroll TWHP patients.
One of the listed phone numbers, according to NARAL, even went to a Subway sandwich shop.
“I’m not a web engineer or programmer, but if the data going in is inaccurate and inflated, you can’t really blame the website for that,” said Heather Busby, the executive director of NARAL Pro-Choice Texas. “Listing the same provider, or same clinic, ten times under different doctor names or listing a Subway sandwich shop as a medical provider, that’s on the humans who input the data, in my opinion.”
A representative for the Texas Health and Human Services Commission told Rewire that the agency has “some serious disagreement” with NARAL’s findings.
“We don’t agree that multiple offices for the same doctor is a duplicate or that ten doctors at one clinic should be counted as one provider,” said HHSC assistant press officer Linda Edwards Gockel, adding that private insurers count multiple doctors at one location as multiple providers.
Edwards Gockel said the TWHP search results automatically turn up clinics according to capacity.
The TWHP has “good capacity in most areas of the state,” Edwards Gockel added, though staffers who answer the phone at offices and clinics “may not be familiar with the [TWHP] by name,” only with patient ID numbers for those who are already enrolled.
Regardless of those doctors’ and clinics’ existing capacity, utilization of the TWHP is down more than 25 percent from its past incarnation as the Medicaid Women’s Health Program, when Planned Parenthood clinics saw about half the program’s enrollees.
“We don’t know all the reasons for reduction in services provided,” said Edwards Gockel, who ventured that “many women chose to stay with Planned Parenthood” even after it was blocked from providing TWHP care.
She added that Planned Parenthood also “routinely enrolled women in the former Medicaid program when they would come to their clinics.”
Heather Busby said that the numbers will eventually bear out, regardless of claims made by HHSC and anti-choice lawmakers, whose ouster of Planned Parenthood was “purely a political ploy.”
“They can say they have all the providers in the world, but if people are not getting served by this program, then it’s a failure,” Busby said.