State Holding Public Hearing on Texas Women's Health Program

The Texas Department of Health Services on Tuesday, Sept. 4, at 1:30pm will host a public hearing on implementation of the proposed new rules for the new Texas Women's Health Program – that is, griping about the overall scheme to banish Planned Parenthood as a provider won't do any good. This meeting is about moving forward and doing it.

To recap: last year state lawmakers prompted the rewriting of rules governing the Women's Health Program in order to cut Planned Parenthood, the program's single largest provider, from the loop. While the rules for the WHP had always contained a prohibition on allowing abortion providers to serve clients, until last year that provision had not been used as a wedge to force out PP.

The original intent of the WHP was to operate a federal-state Medicaid-waiver program – for every $1 the state paid in, the federal government kicked in $9 – that would provide family planning and basic health services to women who aren't pregnant and who wouldn't otherwise be eligible for Medicaid unless they were pregnant. The PP clinics providing services to WHP clients are family-planning clinics and do not provide abortion care.

Still, that separation apparently hasn't satisfied the state, which rejiggered the WHP rules in such a way that has made it so that any clinic using the name Planned Parenthood is ineligible to participate. That didn't fly with the federal Centers for Medicare & Medicaid Services, because PP is a medically-qualified provider, so Texas decided to go it alone in paying for the nearly $40 million program – a figure that appears based on the cost of seeing the roughly 115,000 women served in 2011, and without anticipating any growth, which could be substantial if the close to 200,000 women who are currently enrolled in the program, but haven't yet availed themselves of services, were to try to do so.

Whether the plan to go it alone will actually achieve the same success that the original WHP has – saving the state tens of millions related to Medicaid-paid births that have been avoided by increased access to family planning – remains to be seen. Texas' PP affiliates sued, claiming that banning them from the program infringes on First Amendment free speech and free association rights as well as 14th Amendment due process right. Although the district court issued a temporary injunction banning implementation of the rule, a three-judge panel of the 5th U.S. Circuit Court of Appeals disagreed, ruling last week that the new rules pass constitutional muster. But, the appeal court declined to issue an expedited mandate, which would allow immediate implementation of the rules, giving time for PP to appeal. Whether PP will appeal the Fifth Circuit's ruling is still unclear.

Even though the court has given a nod of approval for the state to cut out the largest WHP provider (in 2010, PP served 46% of all WHP clients), there are still other issues for consideration during the public hearing on Tuesday afternoon. Among the proposed rules is one that would impose a gag order on any discussion of abortion by any WHP doctor, with any WHP client – a prohibition that has the Texas Medical Association and the Texas Association of Obstetricians and Gynecologists, among others, crying foul.

The meeting will be held at the Criss Cole Rehabilitation Center at 4800 North Lamar. A map of the location can be found here.

More background on the WHP and the state's attack on Planned Parenthood is here and here.