As the state rolls out its revised Texas Women's Health Program, a central question remains: how to find enough providers to serve the nearly 111,000 women currently enrolled in the program. The current numbers suggest real trouble – but if one Houston-based crisis pregnancy center and Gov. Rick Perry have their way, providers will be made available.
At issue in part is the state's banning of Planned Parenthood clinics from the program. Although the PP clinics in the WHP (which provided care to nearly half of all WHP clients in 2010 and 2011) do not provide abortions, the state considers them "affiliates" of those non-WHP PP clinics that do. When the federal government, which originally provided 90% of the WHP funding, concluded that excluding PP clinics would violate federal law, Perry decided that the state would remake the WHP as a state-run program, keep the ban on PP, and find a way to come up with the $30-plus million in funding previous provided by the feds.
Even more troubling is that it isn't just PP clinics that will be leaving the WHP. Each provider was again asked to recertify its eligibility for the program by May 1 – including confirming that they are not affiliated with an abortion provider. In addition to the 28 PP clinics that did not recertify this spring, 71 other providers – including federally qualified health centers, physicians, and family planning clinics – also failed to recertify for the program, according to the Center for Public Policy Priorities. Together, those 99 providers made up roughly 61% of all WHP claims filed in 2011.
Although 1,928 providers did recertify in May, just 515 actually provided services in 2011, accounting for the remaining 39% of paid claims.
If the current proposed rules for the WHP are accepted by the state, providers and advocates for the program fear that number could shrink even more, thanks to the inclusion of a gag rule that would forbid doctors from any discussion of abortion with their patients. As written, the rule would even forbid doctors from providing information about abortion to their clients who are not enrolled in the WHP. It is a proposed rule that lawmakers, policy analysts, advocates, and doctors alike have told the state health agencies is a major problem because it conflicts directly with medical ethics and will likely drive providers away from the program.
Even if the gag rule is eliminated, will there be enough providers willing to agree to the state's terms? If Cynthia Wenz has any say, the answer will be yes – at least in Houston. She's CEO of the new The Source for Women, a longtime CPC that's remaking itself into a "pregnancy medical clinic" that proposes to be a federal Medicaid-eligible provider and will step into the Texas WHP to provide well-woman checks and other reproductive health services.
When Planned Parenthood moved into its large new digs in Houston, Wenz said, The Source had a choice: Stick with the old-model CPC, an entity often criticized for providing questionable counseling advice without providing any medical services, or become a direct player in women's health care. The choice, she said, was obvious.
According to Wenz, The Source for Women will now have nurse practitioners on staff, and will provide pap smears and sexually transmitted disease testing and treatment. Exactly what types of birth control will be provided, she said, has not yet been decided. However, The Source will not provide anything it considers an abortifacient – including emergency contraception.
Among those supporting The Source's makeover is Perry, who on Tuesday spoke at the group's ribbon cutting ceremony in Houston. "Here in Texas, we've worked hard to strengthen our abortion laws, empower families, and protect our children's future," reads the text of Perry's speech. "We've banned the use of your tax dollars for abortion procedures in Texas, and expanded that ban to include those affiliated with abortion providers in the case of our Women's Health Program," he continued. "We've stood strong ... and proclaimed the truth that protecting the rights of abortion providers and protecting women's health are not the same thing."
For more on this story, including how The Source connects to the Alternatives to Abortion program, see the Newsdesk blog, Sept. 21.
Copyright © 2021 Austin Chronicle Corporation. All rights reserved.