Texas Fight With Obama on Women’s Health May Cut Care

Texas public health officials say women who get family-planning services at Planned Parenthood clinics will struggle to find other providers once the nonprofit group is expelled from the state Women’s Health Program.

A dispute pitting Governor Rick Perry, a Republican, against President Barack Obama, a Democrat, over a state ban on aid to abortion providers or their affiliates is expected to force out the nonprofit organization, which cares for almost half of the program’s 130,000 participants.

“The reason Planned Parenthood had done 44 percent of the business is that the private community and other providers have not stepped up,” said Janet Realini, a San Antonio doctor in family practice who heads Healthy Futures of Texas, a nonprofit organization working to curb teen and unplanned pregnancies.

“There’s no money, it’s a hassle and there’s an anxiety factor for physicians,” Realini said. The program also offers cancer screening and other basic services through clinics.

Perry pledged last week to replace almost $30 million in federal funds for the program that the Obama administration said would be cut off today because of the state ban. Obama has said Texas can’t block federally approved organizations such as Planned Parenthood from participating in programs underwritten by Medicaid, which pays for health services for the poor.

Providers Available

More than 2,500 other providers are poised to offer services for women who now use 44 health centers tied to Planned Parenthood, Perry and other state officials say. The governor hasn’t disclosed the source of state funds he would use to replace the federal money. About 90 percent of the program’s support came from Medicaid, which is jointly funded by states.

“When we dug into the information, there was strong evidence that there were adequate facilities with adequate care,” said Republican state Representative John Zerwas, an anesthesiologist from Richmond and a member of the Public Health Committee in the Texas House.

“You hate to see the nine-to-one federal match go out the door, but it is a reflection of how strong the state feels about this affiliation with the abortion industry,” Zerwas said.

Perry blamed the Obama administration’s “pro-abortion agenda” for the funding cutoff, in a letter last week to Obama. “The federal government should not be in the business of protecting abortion providers at the expense of the health of Texas women,” Perry said in the March 8 document.

‘Errant’ Claim

“Women still have plenty of places to go,” said Catherine Frazier, a spokeswoman for Perry. “The federal government is saying we are limiting access to care and not allowing women to go to all qualified providers, which is an errant statement because the state dictates who the qualified providers are.”

The state’s Legislative Budget Board last year said that cutting family-planning spending over two years to $38 million from $111 million would eliminate services for more than 200,000 women, according to state Representative Dawna Dukes, an Austin Democrat, who spoke at the Planned Parenthood rally.

While the change in funding officially takes effect today, the state won’t stop accepting provider bills until May 1, said Stephanie Goodman, a spokeswoman for the Texas Health and Human Services Commission. The agency will verify provider eligibility during the next six weeks, she said.

Rural Risk

Many women, particularly in more rural areas, won’t receive needed services because of the change, according to leaders of women’s health clinics in Austin, Brownsville and Corpus Christi.

“It’s going to be very hard for others to pick up the slack,” said Martha Zuniga, executive director of the South Texas Family Planning & Health Corp., a Corpus Christi nonprofit organization that operates six clinics and serves about 11,000 people annually. “Those who are uninsured will suffer the most consequences.”

About 26 percent of the state’s population is uninsured, Bill Millwee, the state Medicaid director, told a Feb. 28 hearing of Zerwas’s health committee.

Planned Parenthood has served 20 percent of American women, Cecile Richards, the organization’s president, said at a rally yesterday in Austin. She said Texas has the third-highest rate of cervical cancer in the U.S. In the past year, 12 of the group’s health centers in the state have closed. Plans haven’t been announced for the 44 that remain.

The nonprofit Brownsville Community Health Clinic, with six offices around the southeast Texas border city and a $13 million annual budget, isn’t prepared to handle many more uninsured clients, said Paula Gomez, the executive director. While the state program may cover basic services, providers often aren’t repaid should more serious health issues be detected, she said.

Stepping Up

“The reason Planned Parenthood exists is there is a need for their services,” Gomez said. “We’ll step up to the plate as we can, but it won’t be easy.”

Austin and other cities with broader safety nets than more rural areas can make up for some lost government funding through private donations, said Regina Rogoff, chief executive officer of People’s Community Clinic, an Austin nonprofit provider that helped about 10,000 people with medical needs last year.

“I view this as a way to remove Planned Parenthood from among the provider community, which will fail because they are effective and successful,” Rogoff said.

The dispute is angering women across political parties, according to state Senator Wendy Davis, a Fort Worth Democrat.

‘Only Source’

“When I was a young, single parent, Planned Parenthood was my only source of contraceptives and well-woman care,” Davis said yesterday by telephone. “This idea that somehow existing providers can absorb a tremendous influx of women is absurd.”

A lunch-time rally yesterday in Austin, the state capital, drew about 100 women wearing red shirts and protesting the aid cutoff. Most blamed Perry.

“Everywhere else I’ve looked is unaffordable,” with annual exams costing at least $200, said Julisa McCoy, 23, from McAllen. As a senior at the University of Texas Pan American in nearby Edinburg, she doesn’t have health insurance. She said she fears her access to care will be lost once Planned Parenthood’s subsidy ends.

“Cutting off Planned Parenthood will affect thousands of women,” she said in an interview before speaking at the organization’s Austin rally, which attracted more than 300 people across the street from the state Capitol.

“I went through all of this in the 1970s and we’re just astonished by this movement to change things for women,” said Jane Van Praag, who drove 50 miles from Bartlett to attend the lunch-time protest in Austin. “Women are not second class citizens and I am entitled to autonomy over my body.”

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