At the very end of this story, in which Rep. John Zerwas and Sen. Charles Schwertner, both of whom are physicians in real life, say that they (mostly) stand with Rick Perry on not expanding Medicaid, they also say this:
Regarding the budget cuts in the last legislative session to family planning and women’s health care, both lawmakers said they support an initiative this session to restore funding by way of primary care programs.
“We’re going to recommend a funding level for [women's health] … at about 50 percent higher than what they had originally asked for,” Zerwas said.
That’s mighty big of them, isn’t it? We’ve also recently heard about some similar sentiments elsewhere in the Senate:
Health and Human Services Committee Chair Jane Nelson, R-Flower Mound, touted a recommendation Thursday to add $100 million for women’s health services to the Senate’s budget proposal.
The recommendation was adopted by a working group of senators who serve on the Senate Finance Committee. Nelson heads the working group.
“It’s time for us to unite behind solutions we can all agree are in the best interest of keeping Texas women healthy. I believe in the power of prevention, and our plan will ensure that Texas women have access to the best possible preventive services such as cancer screenings,” Nelson said in a statement.
She also said the state must expand its provider network, provide more access for women in rural areas of the state and “recognize that family planning is a critical component of our efforts to support the health of Texas women.”
Nelson said the Senate’s starting-point two-year budget contains about $114 million for women’s health. Her workgroup proposed adding $100 million for women’s health through the Community Primary Services Program.
That program is different from the family planning program, whose funding was slashed by about $73 million, or two-thirds, two years ago by the GOP-dominated Legislature.
We are also aware of a bipartisan legislative group that is rethinking those family planning cuts. Before anyone dislocates a shoulder patting themselves on the back, however, I’d like to point out that some things, once broken, can’t be fixed.
Now, seven months later, the clinics remain closed. Shaw, who still runs other programs at Hill Country Community Action, recently told me that only 110 clients have called the agency for directions to other providers. The receptionist refers patients to Round Rock or Waco. When I called those providers, I was surprised to find that they could offer me next-day appointments. Though 98 percent of Hill Country Community Action’s clients had received well-woman care for free, this is not the case at other clinics. No longer able to participate in the Women’s Health Program for political reasons, Planned Parenthood in Waco must now charge patients for care. A well-woman exam, for example, costs $99. Women’s Health Program clients can be seen for free in San Saba at a local Scott & White provider, but that clinic charges full-fee to those who don’t qualify: women under 18 or over 44 or who can’t prove that they are legal citizens. An office visit at the Scott & White clinic would cost $83. Similarly, Lone Star Circle of Care in Round Rock provides services on a sliding fee scale based on income. None of their services are free.
It was more difficult to track where other displaced clients had gone. A Scott & White staffer told me by phone that she hadn’t seen an increase in new patients since Hill Country Community Action closed its clinics. Similarly Lone Star Circle of Care, via an email from director of communications Rebekah Haynes, said that the number of patients the Round Rock clinic had seen from San Saba was relatively small. The Planned Parenthood health center in Waco had seen a significant uptick. Danielle Wells, assistant director of communications for Planned Parenthood of Greater Texas, said by email that in 2012, the Waco health center had served 10 to 15 times as many patients from the zip codes once served by Hill Country Community Action as the year before. Clearly, some displaced patients have found new providers, but others haven’t. Time will tell what effect the closures will have on the reproductive health of those others, but public-health policy analysts are expecting an increase in unintended pregnancies and the number of births covered by Medicaid.
Texas’ new family-planning infrastructure is in flux. The Texas Legislature has three months left in its 83rd regular session, and advocates are lobbying for lawmakers to restore money while public-health specialists are scrambling to study the impact of the state’s defunding of family-planning clinics. In San Saba, even if funding is restored, it would be difficult to reopen the clinics. The staff has mostly moved on to other jobs. Gina Woodward now works for her family business, having hung up her stethoscope for good. After months at home, Melody Ball started a job in another field this month. Eva McDuff is still without work. I asked Tama Shaw if she might revive the family-planning program if funds are restored from the state or federal government. “It would take too much startup money, because the facilities are gone,” Shaw said. “We couldn’t start up again. Everything is gone.”
Those are the last three paragraphs in a story about a small community clinic in San Saba that had to close its doors after getting shafted by the 2011 Lege; see also this story from last year about other clinics around the state getting devastated. Some services will be restored in some places for some people, but sometimes you can’t un-ring the bell, or perhaps more appropriately, you can’t un-fertilize the egg. Everyone who voted for those cuts in 2011, no matter what they do this session, will forever have that stain on them.