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Health care access continues to shrink in Texas

Who needs family planning services? I mean, every kid is born to people who want and can care for them, am I right?

About 15 percent of Houston-area clinics that received state funding for family planning services closed their doors because of budget cuts last fiscal year, and another 30 percent have reduced service hours, according to a study published this week.

Following a political firestorm in the 2011 legislative session, state family planning funds were cut from $111.5 million to $37.9 million for the biennium, cutting services to as many as 180,000 women in Texas a year, according to state health department officials. The number of clinics funded by the Texas Department of State Health Services has dropped from 300 to 136 since the Legislature slashed funding, state officials said.

“Ostensibly, the purpose of the law was to defund Planned Parenthood in an attempt to limit access to abortion, even though federal and state funding cannot be used for abortion care anyway. Instead, these policies are limiting women’s access to a range of preventive reproductive health services and screenings,” a team of academics from the University of Texas at Austin’s Population Research Center wrote in the New England Journal of Medicine article.

That report can be found here, via this Trib story that notes a total of 53 such clinics closed their doors statewide.

In addition, the report states, many clinics are now charging for services that were previously free, raising prices for other services and restricting access to more effective methods of contraception that are more expensive.

To meet the requirements of the new priority funding system, the Department of State Health Services told the researchers that the state stopped funding 35 of 76 family planning clinics in the 2012-13 biennium. The budgets of family planning clinics that still received funding were reduced by up to 75 percent. As a result, about half of the clinics that closed — 25 — were family planning clinics, according to the report.

Well-woman exams and contraception “remain out of reach for some of the poorest women,” sociologists conclude in the report. “The organizational leaders we spoke to reported that women who can pay the newly instated fees are choosing less-effective methods, purchasing fewer pill packs, and opting out of testing for sexually transmitted infections to save money.”

State Rep. Bryan Hughes, R-Mineola, said at The Texas Tribune festival on Saturday that many programs took financial hits last session because of the state’s budget shortfall. Funding that was cut from family planning “went to pretty noble places,” such as programs for children with autism. He also said the tiered funding system lawmakers implemented has brought new women’s health providers to his rural district.

But state Rep. Donna Howard, D-Austin, disagreed with Hughes. She said family planning providers in her district have told her that many clients can no longer afford to see them because they have to charge for services that were free before.

“We have the highest uninsured rate in the country,” Howard said at the festival. “If we want people who do not have the means to provide their own health care to be able to be healthy productive citizens, then, absolutely, we need to be looking at supporting family planning.”

And the Republicans, led by Rick Perry and Greg Abbott, are doing everything they can to ensure that Texas maintains that national lead in uninsured population. Again, there is nothing in the Republicans’ decade-long control of the state to indicate that they consider this to be a problem. And you have to love Speaker wannabe Hughes‘ excuse for cutting family planning: It was either that, or we stick it to the autistic kids. Because there were absolutely no other possible options available to them.

Former Trib writer Thanh Tan, now living in Seattle, puts all this into a national context.

And what are the consequences of cutting off family planning funds to women in a state like Texas? The Legislature’s own non-partisan budget team predicts at least 20,000 additional Medicaid births, for one thing. We’ll have to wait and see whether that actually happens. The National Latina Institute for Reproductive Health has reported higher-than-normal rates of diagnoses and death from cervical cancer along the Texas-Mexico border. It’s worth noting that cervical cancer is treatable if detected early. The greater challenge is convincing women to get screened in the first place.

So why do I care about this issue so much, even though I’m no longer living in Austin?

Overall, the left-leaning Center for Public Policy Priorities points to Census data that shows the U.S. added 2 million kids in the last 10 years– half of that growth came from Texas. One in 11 kids in the U.S. is a Texan. They’re growing up in an education system that lawmakers underfunded this biennium by $5.4 billion. The textbooks they’re learning from are highly controversial. Public schools only teach abstinence, even as the teen pregnancy rate ranks 4th in the nation.

For now, Texas is responsible for all those kids. But someday, they will grow up. Like me, they may even head to the Pacific Northwest. Therefore, I believe we all have an interest in ensuring that Texas women are healthy and become parents when they are ready. I admire those who choose to follow through with an unplanned pregnancy and become parents. But in too many cases, the consequences can be disastrous. I’ll never forget the experience of walking through an emergency shelter in San Antonio that was filled to capacity with abused and neglected children. The executive director told me it was a daily struggle to convince some kids they didn’t have to stuff their pockets with food.

Many opponents of family planning in Texas say they made the tough decision to reduce funding because of budget woes. Others deny birth control works. Most Republicans in the Legislature accuse Planned Parenthood of using the funds to prop up their abortion services. It’s all balderdash — claims based on political ideology over reason and science.

Federal studies have shown that for every dollar the state invests in family planning, more than $3 is saved. Helping women plan and space their pregnancies often means that they and their children will not be born into subsidized health care or have to rely on the state for basic nutrition needs. It’s a way to break the cycle of poverty, promote self-sufficiency and save taxpayers’ money in the long run.

Yeah, too bad we’re not doing any of that. We must love poor people in Texas, we do so much to ensure we have a steady supply of them.

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  1. [...] the same so-called “pro-life” zealots in our Legislature also spent the last session slashing funds for family planning services, thus doing their best to ensure that we have a maximal unwanted pregnancy rate. Sen. Dan Patrick [...]

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