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Texas' Replacement to Planned Parenthood is Providing Health Care to Thousands Fewer Low-Income Women 

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Texas' plan to replace Planned Parenthood services for low-income women with less-qualified health care providers has not produced the gleaming results the state promised. Instead, 44,000 fewer women are enrolled in the state's family planning program for Medicaid-qualified recipients.

This new program, dubbed Healthy Texas Women, has left thousands of low-income women across Texas without qualified family planning providers — and the necessary health services they provide, according to data crunched by the Center for Public Policy Priorities' policy analyst Stacey Pogue.

"Texas made the rosy prediction that former Planned Parenthood clients would be able to readily find alternative providers, but actual experience shows this is not the case," wrote Pogue in a report sent to Texas' Health and Human Services Commission.

She mailed the report Monday — the last day the state would accept public comment on an application it intends to send to the feds, requesting more funding for the Healthy Texas Women program.

Pogue's numbers go all the way back to 2011, when Texas first withdrew state dollars from Planned Parenthood. At the time, Planned Parenthood served more than 40 percent of the clients enrolled in the state's Medicaid Women's Health Program (now Healthy Texas Women)— a program for low-income women that was partially funded by Medicaid dollars. That changed as soon as the state legislature cut Planned Parenthood and all other abortion providers from its state Medicaid budget in 2011 — and worsened in 2013, when lawmakers pulled funds from any clinic that even associated itself with abortion providers or advocated for abortion rights.

The number of Women's Health Program clients accessing family planning services, like pap smear exams and birth control prescriptions, has plummeted under its replacement. According to Pogue's data, sourced from Texas Health and Human Services fiscal reports, some 44,000 fewer women were using the state's family planning program in 2016 than in 2011. What's odd, she notes, is that while the number of clients dropped, the number of eligible providers grew.

HHS racks that imbalance up to the fact that more women are choosing long-acting reversible contraception methods, like an IUD or an injectable contraceptive. In the state's eyes, that means fewer women will need to check in with a family planning provider. But Pogue said there's no way the small fraction of women who receive this kind of contraception in Texas could have made this kind of impact.

Instead, Pogue argues that the growing list of clinics are "providers in name only" — that while the Healthy Texas Women website lists thousands of providers, only a portion of them actively serve Healthy Texas Women clients. And the providers that do see these patients are far less adept at helping a woman access care than Planned Parenthood or other family planning specialist.

"They don't have experience counseling a woman on her options or may not even have the right kind of contraceptive she's looking for," she said. "This isn't their specialty. It turns out these things aren't easy."

A 2016 University of Texas study found that after Planned Parenthood cuts, low-income women who used to rely on its services struggled to find a replacement. Many had to drive long distances to see a provider, pay more for an appointment, and ended up with less effective contraceptives — if any at all. The state's data reflects that.

Pogue points to Texas' skyrocketing pregnancy rate among women covered by Medicaid as the obvious result to limited contraceptive care. Between 2011 and 2014, the number of births by women who formally relied on state-covered injectable contraception from Planned Parenthood increased 27 percent. Then again, Texas did task the Heidi Group, an anti-abortion organization, with connecting Healthy Texas Women clients with new health care providers (a task they also haven't succeeded at).

"Overwhelming evidence shows that expelling Planned Parenthood — a well-qualified, trusted family planning provider...has had adverse effects on women's access to critical preventative health care," Pogue concludes.

The state is asking the feds for an additional $35 million in yearly Medicaid funds to go toward Healthy Texas Women — funds that it forfeited under the Obama Administration for cutting Planned Parenthood. The final draft of the state's application will head to the U.S. Centers for Medicare & Medicaid Services for review.

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