Navigating Possible MAP Detours

If Republican lawmakers have their way at the Capitol, poor women in Travis County may no longer have equal access to reproductive health care. At issue is the Medical Assistance Pro­gram, administered by Central Health, which provides low-income and uninsured women in Travis County with access to counseling, family planning, birth control, and pregnancy termination. It's that last part – access to safe and legal abortion – that's raised hackles Downtown. Two bills, by state Reps. Wayne Christian, R-Center, and David Simp­son, R-Longview (House Bill 561 and HB 85, respectively) would ban local jurisdictions – read, Austin and Travis County – from using local tax money to pay for or, in Simpson's bill, to "support" abortion. A hearing on Christian's bill was held Monday in the House State Affairs Committee. The bill is straightforward; it would simply prohibit a hospital district from using district tax revenue to "finance the performance of an abortion."

Simpson's bill, which has 61 co-authors (including Travis County's GOP freshman Rep. Paul Workman) but has not been set for a committee hearing, is a bit more oblique. The clunky language would prohibit government entities from providing "support to a person or facility that performs abortions or provides abortion-related services." The bill defines "support" as "directly or indirectly using state or local tax revenue to finance an [sic] the performance of an abortion or a service related to an abortion," or "providing preferential access to assets that are owned or controlled by this state or a governmental entity in this state through a lease, contract, or other agreement." In other words, Travis County's Central Health MAP would no longer be able to contract with Planned Parenthood, Austin Women's Health Center, and Whole Woman's Health of Austin, which are the reproductive health care providers contracted to provide services for MAP clients.

Central Health's nine-member board of directors in December 2009 voted unanimously to approve $450,000 in contracts to provide abortion care for low-income women, over the noisy objections of a contingent of pro-life advocates who flooded a meeting of the board that month. But it's not as though the program was actually new. In fact, the city of Austin previously handled the program, which dates back to the 1970s. When the health care district was created in 2004, it was with voters' understanding that these services would not only continue but would be expanded, City Council Members Laura Morri­son, Sheryl Cole, and Randi Shade wrote in a letter to the board in 2009. The language in these bills that would outlaw spending taxpayer funds on abortion services would likely have impact far beyond Travis County.* Indeed, several of the state's public hospitals receive public funds and also provide abortion services in limited and specific circumstances. How either bill would affect them isn't clear. Neither bill addresses serious issues such as exceptions in cases of incest and rape or to protect the life of the mother. If these bills are to go anywhere, these issues will have to be addressed.

Stacy Wilson, director of government affairs for Central Health, says the district is monitoring the bills, and if either were to pass, the district would "have to ascertain ... what that would mean for us." As it stands, however, the MAP simply holds contracts to provide low-income women with the same access to the "full spectrum of services that are available and legal" for women who are insured or have the means to pay for them.

*[Editor's note: In the original, print version of this story, we incorrectly wrote that Travis County is the only political entity in Texas that directly funds abortion care. Actually, Travis County does not directly fund these services, provided through the MAP program. Rather, taxpayer funds support Central Health, which runs the MAP program.