Last month, Jax and I attended a Mom Prom to help raise money for Planned Parenthood of the Texas Capitol Region. Well, really, we went to dance to music from back-inna-day. And dance we did! But raising money for Planned Parenthood (PP) was a very important part of the evening.* Our friend (and loyal reader) B, led the committee that organized the Austin event. Their goal was to raise $1,000 and by the end of the night they raised over $1,250; enough money to provide Well Woman exams for at least 25 low-income women. Way to go B and Company!

Photo by Forza Photography

GG and Jax at the Austin Mom Prom

Jax and I learned from this event. We learned both of us could still squeeze into high school formals; we learned we can dance in high heels for about an hour before they must be discarded; we learned I still know all the words to Queen’s “Fat Bottom Girls” (indeed, they make the rockin’ world go ‘round). But most importantly, and most distressing, we learned our state legislature (affectionately, and sarcastically, called “the Lege” by Texans) was trying to exclude PP from participating in the state-sponsored Women’s Health Program (WHP). WHP is a Medicaid waiver program. It helps women who are not poor enough to qualify for Medicaid, but also do not have private insurance. The program was designed to reduce Medicaid-paid births by providing family planning services, and it has been successful. The program saved Texas about $32 million dollars in 2008 and $63 million dollars in 2009.

The Lege is trying to specifically exclude PP from WHP because PP, as a national organization, is committed to providing all manner of services for women’s reproductive health, including (and here’s the sticking point for the Lege) abortions. There are over 800 PP clinics nation-wide, but not all of these clinics offer abortions. The Lege wants to push all PP’s out of WHP even though many of them don’t offer abortions because all of them are “affiliated” with a national organization that is pro-choice. Note, abortions are never funded by tax dollars.

Why does this matter to the princesses? One, we care about underserved populations. PP serves between 30 and 50% of WHP clients in Texas (estimates vary depending on the source). WHP is a successful program but legislators are proposing to shut out clinics that serve at least 30% of program participants. Huh? Two, PP is so much more than its pro-choice persona. They offer testing, general health exams for women and men, health education for all ages, and counseling for relationships, body image, sexuality and more. PP does great work! And three, we realize this is a tough issue, but we believe in trusting women to make informed decisions for themselves. And we want them to have a safe place to go to talk about their options with a health professional, a parent, a partner, a friend, or whomever they want to include in their decision process.

Like many southern states, Texas has a long history with women’s reproductive rights, which often ends up being about abortion. Political commentator George on the Lege offers a great overview on abortion law in Texas. But my focus is just on the activity in this legislative session.** Here is a run-down on the Lege trying to run down women’s health and reproductive rights:***

Notes: (1) HB = House Bill, (2) SB = Senate Bill, (3) If you click on the link for each bill, you’ll see nine tabs. The second one displays the full text of the bill, (4) If you click on the last tab, you will see how far the bill progressed in the legislative process.

HB 1109 filed on 02.03.2011 — Defines life at the moment of conception. It looks like this bill didn’t go anywhere. Whew.

HB 15 filed on 02.11.2011 — Requires a physician to perform a sonogram on a woman seeking an abortion at least 24 hours prior to the procedure. This bill was signed into law on May 19th and takes effect on September 1st this year. $#@%!

SB 7 filed on 02.16.2011 — It’s a little difficult to describe this gist of this bill as there are 11 subjects covered in it. Yikes! At issue for this post are two amendments to this bill. One would require a woman seeking abortion to share personal information, such as educational attainment, marital status, methods of birth control used, and the reasons she is seeking an abortion. This information would be collected under the guise of “assess[ing] the quality and efficiency of health care.” Another amendment would bar public (tax funded) hospital districts from contracting or affiliating with any organization that provides abortions, abortion-related services, or refers women to an abortion provider. Thus far, this bill has stalled. Whew, again.

SB 1854 filed on 03.11.2011 — Excludes all PP clinics from state-sponsored WHP because at least some PP clinics offer elective abortions. That is, any clinic that is PP, regardless of whether they offer elective abortions, would be defunded from WHP because they are “affiliates” of clinics in the PP system that do offer elective abortions. Never mind that federal dollars cannot be used to fund abortions and WHP is largely (90%) federally funded. And no taxpayer dollars contributing to WHP are used for abortions. There has been no activity on this bill since May 19th. Perhaps there is still hope on this one.

Or perhaps not. In tandem with the above legislative efforts, the Texas commission that houses all state health agencies has been working on a policy to oust PP from WHP since last year. Just to be clear, pushing PP out of WHP will not save Texas any money. Architects of this plan intend for funds that currently go to PP under WHP to go to other health care providers. The commission recently finished that “ousting” work:

“On Thursday, June 9, members of the state Health and Human Services Commis­sion’s Medical Care Advisory Committee voted to approve a new agency rule that would ban Planned Parenthood from participation in the successful Women’s Health Program.” Jordan Smith, June 17th.

At issue is the definition of “affiliate” in current WHP statute.**** The Texas HHSC Medical Care Advisory Committee voted that “affiliate” should henceforth be interpreted to mean (in the context of PP) any PP clinic, regardless of whether that particular clinic offers elective abortions. Sound familiar? Hello SB 1854. How did you find your way out of the legislative process? So much for being “just a bill”.

I am so disappointed. Bill 1854 may have stalled, but since WHP was reauthorized (and thank the gods it was!), the state commission was able to continue its efforts to reinterpret who could receive WHP funds. This is clearly an ideological attack. Legislators do not want elective abortions in Texas, regardless of the fact that Roe vs. Wade made them legal (and continues to protect that right), so they are trying to manipulate funding to push service providers out of the state. Shame on you, legislators, for circumventing law.

Yet, I am still hopeful the remnants of SB 1854 will dissipate with the Lege this year. Indiana tried to pass a similar law, but met with federal resistance. The Department of Health and Human Services basically said, “nice try” but state’s cannot pass a law restricting qualified providers from accessing federal funds.

“Medicaid programs may not exclude qualified health care providers from providing services that are funded under the program because of a provider’s scope of practice.” Donald M. Berwick, June 1st.

What do you think, readers? Are similar bills being proposed in your states?

* I used to work in public health — for the Texas Department of State Health Services in the maternal and child health unit. Providing affordable health care to women and children in need is an issue close to my heart.

** The Texas legislature is biennium – it meets every two years. This year, session began on January 11th and closed on May 30th. It happens to be in a special session right now which will end no later than June 29th. Everything discussed in this post has occurred (legislatively) in the last six months.

*** A special thanks to Jordan Smith at the Austin Chronicle. She has been dutifully following the legislature on this issue and I have learned a great deal from her ongoing coverage last fall and this spring. She also graciously answered several of my emails!

**** If you ask the Oracle for “Ghahremani Women’s Health Program (Agenda item 5.b.i),” the first link should be a letter from HHSC Medicaid and CHIP Division explaining the new interpretation of “affiliate.” Jordan Smith explained the issue to me in an email; I will paraphrase her here. Previous HHSC leadership believed a narrow definition of affiliate would conflict with federal law and complicate or delay federal permission to enact WHP. Under advisement from the Texas Attorney General, the new HHSC commissioner believes a narrow definition of “affiliate” is in legal order.

+ A special thanks to B for reviewing this before it was posted!

++ Featured image is “Mother and Child” by Janis Rozentāls.

+++ Photo of GG and Jax at the Austin Mom Prom courtesy of Forza Photograhy.