R.I.P. WHP?

Today Health and Human Services Commissioner Tom Suehs signed off on a controversial new rule designed to exclude Planned Parenthood from participation in the Women's Health Program – and in so doing has likely killed the successful program.

The WHP is a Medicaid-waiver program that provides basic healthcare and family planning services to low-income and uninsured women who would not otherwise be eligible for Medicaid unless pregnant. The program was designed to increase access to preventative health for women and to reduce the number of Medicaid-paid births. It has done both.

This is no small issue for Texas, where more than half of all births are paid for by Medicaid – in 2009 alone that cost $2.9 billion. The first year of the program, in 2007, the WHP served 91,683 women; by 2010, the program served 183,537. HHSC estimates that the number of women served in 2011 (those final numbers aren't ready yet) will show the program grew again.

And although there are some 1,600 WHP providers across the state, in 2010, PP served 46% of all WHP clients – that is, more than 84,000 women.

Now, though, it appears the gains made via the WHP will disappear. At issue is a new rule that redefines the word "affiliate" in order to exclude any PP clinic from participation in the WHP. Essentially, the new rule defines affiliate such that PP clinics that do not perform abortions are considered affiliates of clinics that do – even if that affiliation is simply the shared name.

Texas says it can do this because it is allowed to decide which providers are fit to participate in the Medicaid program; unfortunately, the federal government, which runs Medicaid, appears to feel differently. In December, the Centers for Medicare & Medicaid signaled in a letter that the new rule to exclude PP would not pass legal muster. With Suehs signing off on the rule today it appears negotiation time is over. CMS has not yet returned a request for comment.

The WHP had been a bright spot in the otherwise bleak landscape for women's health in Texas. State lawmakers' gutting of the family planning budget during the 2011 session means that roughly 160,000 women will lose access to preventative healthcare in 2012 – add to that the more than 180,000 women served by the WHP, and the state will have the distinction of having yanked healthcare away from nearly 350,000 needy women.

Not surprisingly, Texas' PP providers are dismayed by the latest move in the state's war on women's health. In a letter sent today to Gov. Rick Perry, Lt. Gov. David Dewhurst, and House Speaker Joe Straus, eight PP CEOs decried the move, which they wrote has been driven "by a few extreme falsehoods circulating at the Texas Capitol."

You can read the letter here.

And you can read more on the WHP and the gutting of the family planning program here.