Women's Health: Ideology First!
Texas lawmakers do their part to defund Planned Parenthood
The Health and Human Services Commission on April 8 released to stakeholders a draft of its proposed new definition of "affiliate," which would tighten the list of providers eligible to receive funding to support the successful Women's Health Program. The WHP is a Medicaid-waiver program designed to provide reproductive health care to women who would only become eligible for Medicaid services should they become pregnant. The idea is to lower the number of Medicaid-paid births in the state – Texas has one of the highest percentages, with 56% of births paid for by Medicaid, at a cost of $2.7 billion in 2009. The program was begun as a five-year demonstration program that's set to expire this year unless state lawmakers renew it (the conventional wisdom is that they will re-up). In 2008 alone, it reduced the number of Medicaid births by more than 10,000 and saved the state roughly $42 million. At issue now, however, is which health care providers can actually participate. Sen. Robert Deuell, R-Greenville, last year asked Attorney General Greg Abbott whether Planned Parenthood could be excluded from funding because some of its clinics provide abortion services. Even though none of the taxpayer funds associated with the WHP are used for abortions, Deuell was seeking permission to deny funding even for the clinics that don't provide those services under the notion that all Planned Parenthood clinics are "affiliates" of one another – as such, even those that don't provide services would be linked (perhaps in name only) with those that do. Abbott opined that the family-planning provider could be kept from participation under this theory, clearing the way for HHSC Commissioner Tom Suehs to have his agency craft a new definition of "affiliate" that would, in essence, connect Planned Parenthood clinics as affiliates of one another, thus accomplishing the goal of defunding their participation in the WHP.
The new language given to stakeholders – doctors' groups, abortion opponents, family-planning clinic representatives, and, of course, Planned Parenthood – describes an affiliate of an abortion provider as "any individual or entity that has a business or professional relationship with another entity that performs or promotes elective abortions. The business or professional relationship must be created or governed by at least one written instrument that evidences a franchise, common ownership, management, or control." The statute governing the WHP would then be tweaked to prohibit funding from going to a group that is affiliated with an abortion provider pursuant to this new language.
More generally, how this change might impact the WHP isn't entirely clear; currently, Planned Parenthood providers serve 40% of all WHP clients. Whether there will be enough providers to pick up that slack or to expand the program – as the Legislative Budget Board has recommended – remains to be seen. Also, because the program received federal approval before the new definition was created, the feds may have to weigh in before it can be implemented. Moreover, it is unclear whether Planned Parenthood might legally challenge the new provision. Lawmakers in 2005 sought to block PP from receiving funds from another pot of federal money earmarked for reproductive health services; PP sued, and ultimately the state lost. As a result of that lawsuit, however, the state's PP clinics legally separated themselves from one another to avoid having any connections among clinics that do and do not provide abortion services. Whether, and how, that dissociation will play into the current attempt to cut them out of the loop remains to be seen.