All The King's Horses and All The King's Women...Fixing What They Broke
By Reps. Jessica Farrar, Dawnna Dukes, and Donna Howard
As recognized leaders in the area of women's health in the Texas Legislature, we have been deeply troubled and outraged by lawmakers' actions in recent years which have strongly compromised access to women's health services in the state, particularly the dramatic cuts to family planning funding in 2011. Leading up to last year's 83rd Legislative Session, we worked tirelessly to bring attention to the devastating impact of those cuts, and to educate our colleagues on the resulting closure of clinics throughout Texas. We were grateful to have bipartisan majorities in both the House and Senate come together and restore funding for family planning, albeit to a different system of delivery. However, it now appears that some of our Republican colleagues are choosing to use this momentary display of common sense as a means of rewriting the past, and excusing their actions in the time that has followed.
The year 2011 was disastrous for women's health in Texas. The Legislature cut family planning funding by two-thirds - a loss of $73 million - despite projections from the Legislative Budget Board that this action could result in 20,500 unplanned pregnancies, costing the state an extra $230 million in Medicaid expenditures. Additionally, new legislative mandates resulted in the state ending its participation in the Medicaid Women's Health Program (WHP), leaving about $30 million in federal funds on the table annually. Contrary to any claims that these changes were somehow related to the recession, these actions were a coordinated, politically motivated attempt to bar a single qualified provider - Planned Parenthood - from receiving state funding. As if it weren't bad enough that the state's single largest provider of women's health services was shut out, the Legislature's decisions resulted in the shuttering of dozens of additional clinics who had zero affiliation with Planned Parenthood. And ignore the abortion red herring - state dollars were already and continue to be prohibited from funding abortions.
Following the protests and entreaties of health advocates and medical professionals, the state has since taken some steps to reverse course, but these advances have come with problems of their own. The Health & Human Services Commission replaced the highly successful federally-funded WHP with a Texas version, sans Planned Parenthood, now paid for completely at state expense. Furthermore, the rollout of the Texas Women's Health Program website was disastrous, its list of providers has been artificially inflated and riddled with errors, there's still no sign that its provider network can make up for the loss of Planned Parenthood, and enrollment and claims have both dropped significantly compared to the old WHP. And though the Legislature secured $100 million for a new Expanded Primary Health Care for Women program and expects to direct 60% of those funds toward family planning services, once again, the provider network is questionable, and the delivery of services is anticipated to be much more costly than the previous system. All the king's horses and all the king's women can't quite put this program back together again.
The state's family planning safety net took years to build, and the 76 clinics that were forced to close since 2011 will not be easily replaced. Even if everything goes according to plan, the current system is expected to serve only about one-third of Texas women in need of these services. Keeping this in mind, it's difficult for us to be wildly complimentary of our Republican colleagues who voted to destroy a successful program and then congratulate themselves for restoring dollars to clean up the mess. And though we will continue to push our fellow legislators to address our state's rate of uninsured - the highest in the nation - by adopting Medicaid Expansion and by embracing the Affordable Care Act, which provides women with preventive services, including contraceptives, with no co-pay, we still feel rage over 2011's cuts and last summer's two special sessions on unnecessary anti-choice legislation.
Make no mistake, we would love to stop talking about the war on women. But for that to happen, Republicans - including so-called Red State Women - will need to stop inserting themselves into the doctor-patient relationship, refrain from any further obsessive attempts to reduce access to legal reproductive health services, and quit using anti-woman legislation to boost their chances in a primary election. Until then, we'll call 'em like we see 'em.
Rep. Jessica Farrar has served in the Texas House since 1995, and represents Harris County. Reps. Dukes and Howard have served since 1995 and 2006, respectively, and represent Travis County.