Texas' Latest Attack on Women's Health

Statement from Raegan McDonald Mosley, Chief Medical Officer, Planned Parenthood Federation of America:

This is yet another backdoor attempt to cut off people’s access to health care at Planned Parenthood. Women in Texas are already suffering and dying because of the state’s callous disregard for their health and well-being. This is hardest on women who already face barriers to health care, especially young women, women of color, those who live in rural areas, and women with low incomes. The Trump administration must shut down this latest attack women, because if the rest of the nation goes the way of Texas, it would result in a public health crisis  for millions of women.

Background:

The state of Texas has asked the Trump Administration to bend the rules and upend longstanding federal policy in a backdoor attempt to “defund” Planned Parenthood and cut off women’s access to health care. In a request submitted to the Administration, the state makes clear its plan to seek federal approval and funding for its ill-fated family planning program, the Healthy Texas Women (HTW) Program. This is a program created to block access to care at Planned Parenthood that, by every measure, has failed to fill the tremendous unmet need for healthcare. Prior to being banned from the program, Planned Parenthood affiliates served more than 40% of patients in the program (approximately 50,000 of the around 111,000 patients in the program). The state’s own numbers show that two years after barring care at Planned Parenthood, nearly 30,000 fewer women received birth control, cancer screenings, and other care as a result. There was also a 27 percent increase in births among women who lost access to injectable contraception.  

If the administration grants this request, it would double down on a program that was designed to limit women’s access to health care and resulted in poorer health outcomes for women. Even worse, it could pave the way for other states to follow Texas' dangerous lead, with grim consequences for women’s health nationwide.

This is unprecedented. Never before has the federal government allowed a state to cut off women’s access to qualified family planning providers in  Medicaid. Federal policy has long safeguarded the right of Medicaid patients to access health care at any qualified provider -- and for good reason. Texas shows the devastating consequences for women’s health when politicians block care at qualified providers like Planned Parenthood.

Texas ranks #48 in the nation in maternal and child health. Texas’ maternal mortality rate is higher than in any other state and unmatched by any other industrialized country. Even more alarming, these rates are disproportionately high among Black women.

Planned Parenthood’s Irreplaceable Role:

• Fifty-four percent of Planned Parenthood’s health centers are in rural or otherwise medically-underserved areas. That means for many patients, without Planned Parenthood, they would have nowhere else to go.

• The Congressional Budget Office estimated that cutting off access to care at Planned Parenthood would result in at least 370,000 women losing access to care.  

• In 68 percent of counties with a Planned Parenthood health center, Planned Parenthood serves at least half of all safety-net family planning patients.

• Nationwide, Planned Parenthood serves 32 percent of women receiving contraceptive care from safety-net family planning centers, even though they comprise only 6 percent of such centers.

• Planned Parenthood health centers were much more likely to offer the full range of FDA approved methods when compared to federally qualified health centers (FQHCs) and health departments (93% vs. 52–61%).

• The majority of Planned Parenthood health centers offer extended hours, same-day appointments, and have shorter wait times for an initial visit, compared with all other types of publicly-funded health care providers.

• Cutting off access to health care is hardest on people who already face systemic barriers accessing health care — especially people of color, young people, people with low to moderate incomes, and people who live in rural areas.

Public Health Experts Agree -- “Defunding” Planned Parenthood is Devastating for People’s Health:

• “We know public health has deteriorated in Texas. We know fewer women are getting care. They clearly didn’t get the performance that they got when Planned Parenthood was part of the program.” -- Dr George Benjamin, president, American Public Health Association, Guardian, 5/11/17

• “Five years ago, we learned in Texas what can happen when efforts to defund Planned Parenthood are carried out: The network of health-care providers falls apart and women lose access to essential preventive services.” -- Joseph E. Potter and Kari White, Texas Policy Evaluation Project, Washington Post, 2/7/2017

• “To assume that health centers are in a position to fill the void left by barring a health care provider of Planned Parenthood’s importance to Medicaid beneficiaries...is simply wrong,” – Sara Rosenbaum, George Washington University, Health Affairs, 1/27/17

• “We are seeing a subsequent rise in STDs and a subsequent rise in unplanned pregnancies [after the state cut off care at Planned Parenthood]. And I’m sitting here going, ‘See? I told you so. This is what happens.’” -- Mike Austin, chief executive, Midland Community Healthcare Services (MCHS), The Guardian, 1/17/17

Outsized Impact to Women of Color

• It is well documented that people of color in the United States are disproportionately unable to access quality health care due to the intersections of racism, sexism, classism, xenophobia, and other systemic barriers, making them more likely to rely on Medicaid. Dangerous policies like those enacted in Texas exacerbate these systemic barriers for Black and Latino communities.  

• In a 2015 study, more than half of Texas women reported at least one barrier to reproductive health care. Spanish-speaking women from Mexico were more likely to report three or more barriers.

• Planned Parenthood health centers in Texas served more than 33,000 Latino patients and more than  21,000 Black patients in 2014.  Nationally, Planned Parenthood health centers serve around 370,000 patients who identify as African American or Black and around 575,000 patients who identify as Latino.

• Policing and politics — including border patrol checkpoints and increased funding to border militarization efforts — already make it nearly impossible for many immigrants to access health care, including prenatal care, birth control and other reproductive health care. Too often, poverty, lack of transportation, and the risk of detention and deportation interfere with access to health care in these communities.

• In Texas, and across the country, immigrants are less likely to receive screening for and more likely to die from breast and cervical cancers. In colonias, or border counties along the U.S. and Mexico border, many immigrants live in medically underserved areas. Many people lack public transportation, forcing them to go to tremendous lengths to access the care that they deserve.