“Jane Doe 8,” as she’s identified in the court documents detailing her story, finally called Planned Parenthood in Houston after several other doctors told her they wouldn’t accept her Medicaid insurance.
The 24-year-old single mother, living in a small town in Montgomery County, wanted the Depo-Provera birth control shot, but her list of doctors, provided by Medicaid, was just a list of dead ends, according to a statement she submitted to a federal in Austin.
Until she found Planned Parenthood. There, she was able to walk in and get an appointment right away.
“With two small children at home, if I can’t see a doctor quickly, I may not be able to see one at all,” the woman wrote as part of a lawsuit challenging Texas’ latest attempt to eliminate Planned Parenthood from the Medicaid program.
Ten anonymous patients and three Texas Planned Parenthood affiliates filed the legal challenge almost three weeks ago, after Texas launched an effort in October to boot the health care provider from the joint state and federal Medicaid program. State officials have pointed to secretly recorded, deceptively edited videos filmed by the California anti-abortion group Center for Medical Progress (CMP) as evidence of “numerous acts of misconduct” necessitating the organization’s ouster from Medicaid. Attorneys for Planned Parenthood are asking U.S. District Judge Sam Sparks to allow the provider to continue treating Medicaid patients while the lawsuit plays out. Lawyers for both the plaintiffs and the state had been scheduled to appear in federal court on Monday, but on Tuesday, Sparks canceled the hearing indefinitely.
In court documents, Planned Parenthood and its patients argue Texas has violated the federal Social Security Act, which allows Medicaid patients to choose their own health care provider — even Planned Parenthood. Specifically, plaintiffs say that patients “will lose their provider of choice, will find their family planning services interrupted, and in many cases will be left with reduced access to care.”
As part of the federal suit, the ‘Jane Doe’ plaintiffs describe themselves as single mothers, college students and rape survivors. All are asking the court to let Planned Parenthood stay in the Medicaid program.
Another plaintiff, “Jane Doe 10,” who lives in Austin and works as a line cook, writes in her declaration that being able to pick her own doctor assured her that she could access health care without judgment. A rape survivor who grew up in the foster care system, the woman describes the emergency physician she saw after her assault as “not empathetic or helpful. This experience made me very nervous around doctors.”
But, she wrote, Planned Parenthood was a place she felt safe.
“Between being raped, my traumatic experience in the ER, and the fact that my family background is extremely conservative about sex, I found it very difficult to go in for the appointment to get care,” the 20-year-old wrote in her statement. She now visits a north Austin Planned Parenthood for birth control, STI testing and other reproductive health services.
“I have built a relationship of trust with the staff at [Planned Parenthood], and I am comfortable there,” she wrote. “It is an open and accepting environment. I am not as comfortable with other doctors.”
Low-income Texans already face obstacles when accessing family planning and other preventive health care services. The Texas Legislature has for years toyed with family planning funding, and in 2011, conservative lawmakers led a successful effort to kick Planned Parenthood out of the Medicaid Women’s Health Program, which resulted in thousands fewer women being served through the program. Most recently, the state eliminated Planned Parenthood from the Breast and Cervical Cancer Services program, leaving parts of the state without a provider.
Texas Medicaid, at the center of this most recent lawsuit, already has some of the strictest eligibility requirements in the country, serving predominantly pregnant women, very poor seniors and children. For a woman to get family planning services through Medicaid, she must be very poor — earning less than approximately $3,000 a month — not be pregnant, and have one child already. Every year, more than 13,000 poor Texas Medicaid patients get birth control, cancer screenings, and STI and HIV testing at Texas Planned Parenthood health centers. A mother of three and full-time student living in Pflugerville, “Jane Doe 3” wrote that she would struggle to afford her birth control shots, annual Pap smear and STI testing without Medicaid. She has been a Planned Parenthood patient for eight years and wouldn’t know where to turn without the provider.
“I would be afraid that I would end up at a health center where people disrespect me for being on Medicaid and treat me like I’m lazy and that’s why I don’t have private insurance, or that I would end up somewhere where I am not satisfied with the quality of services,” she wrote.
Republican and anti-abortion lawmakers, both in Texas and Congress, have targeted Planned Parenthood funding for years, but have escalated their efforts since this summer’s release of the CMP videos.
While anti-abortion lawmakers have long argued that other health care providers can fill the void left by eliminating Planned Parenthood, experts say it’s not that easy. Only 37 percent of Texas physicians accept new Medicaid patients, according to the 2014 Texas Medical Association’s biennial survey.
“It is difficult to find a good provider who will take Medicaid patients,” wrote a plaintiff identified as “Jane Doe 9,” in another declaration attached to the suit. The 26-year-old mother juggles caring for her four-year-old son with classes at Houston Community College and a part-time job on campus. When seeing other Medicaid providers, she wrote, she has waited up to two hours for her appointment.
“I am worried that I would end up at a provider that is farther away and more difficult to get to or has long wait times,” she wrote. “I am already stretched very thin between school, work, and my son, and I cannot afford to have it be more difficult to get health care.”
The federal government has already warned Texas that its actions might be illegal, and, most recently, federal judges in Alabama and Louisiana have stepped in to block their respective states from booting Planned Parenthood from Medicaid.
According to Sparks’ order, the initial hearing regarding Planned Parenthood’s request for a preliminary injunction has been canceled “until further order of the court.” Planned Parenthood officials say they will continue providing services to Medicaid patients.
Requests for comment from the Texas Health and Human Services Commission and Texas Attorney General’s Office were not immediately returned.