Defund Planned Parenthood ... Jeopardize Lives
Women's health care in the budget crosshairs again
Sharp abdominal pain coupled with bleeding last April troubled an otherwise healthy Gay Norman. If it weren't for the recent loss of her close friend, who died suddenly from a blood clot caused by an ovarian cyst – untreated due to lack of insurance – the 57-year-old, similarly uninsured Texan might have ignored the pain.
"After Bailey died, I promised I wouldn't let something like that happen to me," said Norman. A friend referred her to Planned Parenthood Waco – her first visit to the reproductive health network in more than two decades – where she received a Pap test through the Texas Breast and Cervical Cancer Services program. The test determined Norman was suffering from ulcerated cervical lesions and connected her with an oncologist, who diagnosed her with cancer. Two weeks later she enrolled in Medicaid and began chemotherapy. Today, Norman is in remission, but says if it weren't for the life-saving, preventative program she might not be alive to tell her story.
"If I hadn't had them, if I hadn't had that program, I don't know what I would have done," said Norman, a single, self-employed woman with few resources. "I feel like I'm alive because of them."
Despite the success of the BCCS program, the Legislature – on its perennial quest to eviscerate Planned Parenthood – is seeking to strip BCCS funding from the health care provider. The proposed Senate budget establishes a new tiered-system funding formula that prioritizes funding for state, county, and community health clinics, federally qualified health centers and clinics, followed by "non-public entities" that provide screenings as part of comprehensive primary and preventative care, and lastly, "non-public entities" that provide the screenings but not comprehensive primary and preventative care – i.e. Planned Parenthood. In a nutshell, under the Senate budget proposal, Planned Parenthood would effectively be last in line for federal and state funding.
The Lege's latest ideological attack on abortion providers is explicit. "There are many members that feel very strongly that the facilities that receive that funding should not be facilities that are performing abortions, so the answer is: Don't perform abortions and you get the money," chair of the Senate Committee on Finance, Sen. Jane Nelson, R-Flower Mound, told reporters. "I get it, but it's also important that we have enough entities that provide services to women so that they can receive those services, and that's my goal." The express intention is to ensure Planned Parenthood is punished for providing abortion services (although those services are not underwritten by public funds) – regardless of the collateral damage those funding cuts may inflict on women.
Planned Parenthood and other providers are still coping with the impact of the 2011 Legislature's massive budget cuts to family planning. That session instituted a similar three-tiered priority system that pushed Planned Parenthood and specialty family-planning providers to the lowest rung, assuring nearly 80 clinic closures and effectively excluding more than 280,000 low-income women.
In 2013, the Health and Human Services Commission followed suit, implementing a rule excluding Planned Parenthood from the Medicaid-funded Women's Health Program (which provides cancer screenings and other preventative care), ending annual care at Planned Parenthood for at least 50,000 poor and uninsured women. Under the new system, according to data from the HHSC, comparing just May 2012 to the same month in 2014, more than 11,000 fewer women received preventative, life-saving services.
"We have seen exactly what happens to women when our state tries to meet a political goal instead of a public health goal," said Sarah Wheat, vice president of community affairs at Planned Parenthood of Greater Texas. "The safety net for women's health care has been completely shredded as a result. So we are very concerned that the same political strategy is being used with the BCCS funding."
The cancer screening and diagnostic program, administered through the Department of State Health Services in partnership with the Centers for Disease Control and Prevention, has served 374,109 women in Texas since 1991 (33,599 last year). Planned Parenthood affiliates alone serve about 3,000 women a year. Of PP's patients, 35% are Hispanic; 20% African-American; and 40% Anglo. The program aims to assist uninsured women over 18 years of age who earn income up to 200% of the federal poverty level – offering clinical breast exams, mammograms, pelvic and HPV exams, biopsies, and Pap tests to prevent and detect cancer in its earliest stages.
In a state that has one of the country's highest incident and mortality rates of cervical cancer, according to the CDC, enrollment in the program can mean life or death. "This is a very important population to serve," stressed Wheat. "These are life-saving services that help uninsured, low-income women who have very few resources when it comes to health care and are in need of immediate access."
In fiscal year 2014, the BCCS program received $2.4 million in state funds and $7.8 million in federal funds, according to DSHS. While the three Planned Parenthood locations in Austin do not offer the BCCS program, it is offered in surrounding areas, including Temple, Tyler, Denton, Plano, Mesquite, Dallas, and Fort Worth, and is the lone provider in Waco, where Norman received her care. "I find it really sad," she said of the Senate plan. "I imagine how many other lives this program at Planned Parenthood saved and what women like me would do without it." The recovering cancer patient hopes to depend on the program for annual checkups for years to come – but like so much of the women's health care network in Texas, that life-saving service remains under threat.