Another legislative session, another attempt to strip Planned Parenthood of funding.
This time, the proposed Texas Senate budget jeopardizes a screening program that serves Texas women who are at greatest risk for developing breast and cervical cancer. Some senators want to resurrect a strategy that would put Planned Parenthood and other specialty health clinics at the bottom of a list to receive funding for breast and cervical cancer services.
Administered by the Texas Department of State Health Services, the program provides a plethora of services for uninsured, poor women, including Pap smears and mammograms, diagnostic services such as biopsies and ultrasounds, as well as expedited assistance for Medicaid coverage for cancer patients.
“We’ve already reduced access to women with the greatest need,” said Ana Rodriguez Defrates, Texas policy director with the National Latina Institute for Reproductive Health. “We’re talking about reducing access for women who haven’t had a Pap smear in years. To do anything other than increase the number of providers when we know this to be true is a travesty.”
The Senate proposed budget includes a provision that would create a three-tiered system for program providers, putting Planned Parenthood last in line. Money would flow first to the top tier—public entities like state, county and community clinics. “Non-public” entities or clinics that offer cancer screenings as part of a broader “comprehensive primary and preventative care” package would be next in line. Finally, the third tier would consist of specialty providers, including Planned Parenthood.
The goal, as lead budget writer Sen. Jane Nelson (R-Flower Mound) and Health and Human Services Committee Chairman Sen. Charles Schwertner (R-Georgetown) have acknowledged in recent weeks, is to keep state money away from health care providers that also perform abortions, even though no public dollars fund the procedure and Planned Parenthood clinics that offer such services are completely independent from its health centers. Sen. Kirk Watson (D-Austin) said he’s concerned about the proposal and the consequences it will likely have on access.
“This so-called three-tiered approach has the very intended consequence of wiping out at least a provider that is integral in making sure that women that don’t otherwise have access to care,” he said. “There’s collateral damage to that as well; there are providers that aren’t the targeted provider that also get hurt.”
In 2014, with $2.4 million in state funding and $7.8 million in federal funding, 41 providers offered services at 196 clinics statewide, according to the Department of State Health Services. Of the 34,000 women served, about 10 percent received cancer screenings and diagnostic services at a Planned Parenthood clinic, said Sarah Wheat of Planned Parenthood of Greater Texas. She sees the tiered funding strategy as a political move.
“What we know from experience is that when the Texas Legislature sets up a political goal for women’s health funding, uninsured women lose access to these essential services,” she said.
It’s a strategy Republican lawmakers have tried before. In 2011, on top of a two-thirds funding cut to the state’s family planning program aimed largely at defunding Planned Parenthood, lawmakers passed a budget that tiered funding for family planning providers. Planned Parenthood’s health centers and other specialty family planning clinics were bled even more by the tiered system. The fallout was catastrophic: More than 50 family planning clinics, largely non-Planned Parenthood clinics, closed and nearly 150,000 women lost services. While the Legislature did restore some of the funding in 2013, the programs are still only serving about 32 percent of the women in need. The state also lost federal money when it wrote Planned Parenthood out of the Medicaid Women’s Health Program, which provided birth control to poor, Medicaid-eligible women who weren’t pregnant. The state-funded program the Legislature has created since hasn’t quite kept up. Before losing the federal funding, the program served approximately 127,000 women, according to the Health and Human Services Commission. The state program now serves approximately 115,000.
Texas is likely to lose more providers if the Senate budget proposal goes through, advocates and providers fear. The regional impact and the number of other specialty, non-Planned Parenthood clinics that may fall into the third category are unclear.
Of the approximately 34,000 uninsured women served in the program, the majority are women of color. According to the Kaiser Family Foundation, the incidence rate of cervical cancer among Texas women is 17 percent higher than the national rate, and Hispanic women in Texas are more likely to be diagnosed with cervical cancer than African-American or white women every year. Hispanic women along the Texas-Mexico border are 31 percent more likely to die from cervical cancer compared to their peers living in non-border counties, said Rodriguez Defrates.
In his State of the State speech this week, Gov. Greg Abbott called for an additional $50 million for women’s health services, including life-saving breast and cervical cancer screenings. The governor’s office told the Observer further details on the budget, including how the women’s health funding would be allocated, aren’t available yet.