Thursday, August 23, 2012

Women’s Health Care: The Sound of the Other Shoe Dropping

By Janet Realini, MD
President, Healthy Futures of Texas

On Aug. 22, the 5th U.S. Circuit Court of Appeals lifted the temporary injunction that kept Texas from excluding Planned Parenthood clinics from participating in the Texas Women’s Health Program (WHP).

Planned Parenthood’s lawsuit to stay in WHP is due to be heard in federal district court in October, and the 5th Circuit’s decision means that the state can move ahead with removing Planned Parenthood clinics as providers while the lawsuit proceeds.

WHP provides preventive care, cancer and other screenings, and contraception to about 130,000 low-income Texas women each year, but does not provide abortions. Planned Parenthood clinics have been offering the preventive care to about half of WHP patients, and it is doubtful that the state can recruit enough active providers to fill the void.

This is the second big shock to preventive health care for low-income and uninsured Texas women. In its efforts to defund Planned Parenthood, the 2011 Texas Legislature gutted the Department of State Health Service (DSHS)’s Family Planning program. These deep cuts hit 146 clinics and closed 60 of them (only 12 of which were run by Planned Parenthood). As noted by the Texas Observer, low-income women in many areas of Texas already face long drives, or even complete lack of access to birth control and health screenings.

The two-thirds ($73 million) cut hit public hospitals, Federally Qualified Community Health Centers, and small specialty clinics around the state. These are exactly the providers that could have been able to help serve more WHP clients – if they had not downsized or closed due to the DSHS family planning cuts.

Like many TMA physicians, I am distressed to see the women’s health care safety net in tatters. About 1.4 million Texas women need basic preventive care, including access to contraceptives. Even before the cuts and loss of providers, Texas’ safety net was big enough to reach only about one in five of these women in need.

It makes no sense to restrict access to preventive care and birth control. This short-sighted cutting of access to contraception will mean more unplanned pregnancies, with less prenatal care, more complications, and higher risks for babies. It also means higher costs for the state, as taxpayers pay for the Medicaid deliveries, the NICU care, and the many health and social costs of unplanned pregnancies.

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