No More WHP? WTF?!

by Jason Stout

With the session winding down, lawmakers under the dome are poised to deny basic health care to hundreds of thousands of women – in the name of reducing abortion.

As things stand, a bill to reauthorize the successful Women's Health Program is dead. Senate Bill 1854 by Sen. Robert Deuell, R-Greenville, would have continued the program – which in 2008 alone saved the state more than $40 million in Medicaid-related costs and reduced by more than 10,000 the number of Medicaid-paid births. And, in an unrelated move, House lawmakers last week voted, yet again, to make it even harder for low-income women to access vital reproductive health services.

Although the WHP is very popular on both sides of the aisle, Deuell inserted in his bill a poison pill that his colleagues apparently will not abide: Should conservative lawmakers' attempts to keep Planned Parenthood from providing WHP services fail in court, the state would simply eliminate the program altogether. This is part of an ongoing strategy to defund Planned Parenthood – and, barring its elimination (which conservative lawmakers will not accomplish no matter how hard they try), to keep PP from receiving any government money to provide health care services to low-income women. The assaults on women's health care are done in the name of ending abortion, but blocking women's access to health care raises the perverse possibility of increasing the instance of abortion; according to the Guttmacher Institute, in the absence of reproductive health care for low-income women, Texas' abortion rate could be expected to increase 22%.

Regardless, the WHP, a Medicaid-waiver program that provides basic health care services to low-income women who wouldn't be eligible for the government program unless they were pregnant, may lapse entirely because Deuell says the House wouldn't authorize the reup without a ban on PP, which currently provides some 40% of services under the WHP. Whether women have a chance to visit their provider of choice is clearly not of any import to the majority under the dome – the same folks who rail at government-sponsored healthcare in part for eliminating patient choice.

If lawmakers allow the WHP to lapse, some 120,000 clients will be left without access to reproductive healthcare, according to new program participation numbers provided by the Health and Human Services Commission. (If the compromise budget keeps the nearly $62 million cut to the state's family planning program – or further guts the program, which may be the case – that means that a total of more than 400,000 low-income women, and some men, will be left without access to very basic health care services.) Although HHSC could apply to renew the federal waiver without any legislative action it will not do so, HHSC spokeswoman Stephanie Goodman said in an email. Still, whether the program is destined to die is at this point remains unclear – at least until conferees release their final budget compromise (expected Thursday).

Meanwhile, in passing a Medicaid spending bill on May 19, a majority of lawmakers voted to include an amendment by Rep. Jim Landtroop, R-Plainview, that would deny any Medicaid funds to any provider of abortion or "abortion-related services." The problem, of course, lies with the definition of abortion-related. That is a subjective term, pointed out Rep. Helen Giddings, D-Dallas – meaning it's anyone's guess what exactly a service related to abortion actually is. Indeed, asked Rep. Jessica Farrar, D-Houston, does Landtroop believe emergency contraceptives are abortion-related? Yes, he replied. So, does that mean a health care provider who does not hold that view would be penalized for dispensing so-called Plan B birth control? Who, Farrar asked, should decide which view of things is relevant for purposes of the law? "How do you get into [a provider's] head about intent?" she asked. "I don't know," Landtroop replied. Indeed. Nonetheless, lawmakers accepted Landtroop's amendment on a 90-44 vote.