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Women’s health program in Texas under threat of expiration due to abortion ‘affiliate’ exclusion

In Texas, a bill to renew a five-year-old Medicaid women’s health program that is due to expire in December is under threat from passage, all given that entities that receive funding via the program may be affiliated with abortion providers. Case in point: Planned Parenthood.

The program, which the Texas Legislature approved as a five-year demonstration project in 2005, is a Medicaid waiver for uninsured Texas residents whose family size and income (at or below 185 percent of the federal poverty level) puts them at a level at which women are qualified for Medicaid if they were pregnant.

Under Senate Bill 1854, sponsored by state Sen. Bob Deuell (R-Greenville), the program would continue under the name Women’s Health Program but limit participation to providers who offer comprehensive care. Eligible women would be able to receive preventive health and family planning services such as physical exams; health screenings for diabetes, cancer, sexually transmitted diseases and tuberculosis; contraceptives (but not emergency contraception); and a referral to “appropriate providers that are entities or organizations that do not perform or promote elective abortions or contract or affiliate with entities that perform or promote elective abortions.”

As the Austin American-Statesman reports, Deuell — who is a family physician — can’t garner enough support for this bill to bring it to vote in the Senate; part of the issue is the aforementioned exclusion of entities that perform or promote abortions, or affiliates of such entities.

The bill’s text includes an explanation for the abortion-provider/affiliate exclusion: Basically, when the state awards grant money to an entity or an affiliate of an entity that performs or promotes elective abortions -– even if the money is “designated exclusively for purposes that are not related to elective abortions” — taxpayer money is used to support elective abortions. Separating the entity that performs elective abortions from an affiliate of the entity is “insufficient,” according to an opinion from Texas Attorney General Greg Abbott, which cites court cases and state code to come to the conclusion that the Texas Health and Human Services Commission is barred ”from contracting with an entity if the entity has an affiliate that performs or promotes elective abortions.”

A second AG opinion released at the same time authorizes HHSC to define the term “affiliate” as it deems fit. According to a recent HHSC handout, the agency plans to implement the new rules by Oct. 1, with the Medicaid Care Advisory Committee meeting June 9 and HHSC Council meeting June 23.

“It won’t pass the House without that in there,” Deuell told the Statesman. The senator also told the newspaper that Democrats in the Senate won’t vote for the bill as it stands, and at least two ‘yes’ votes from Democrats are needed to move it to a floor debate. “I guess we just won’t renew the program,” Deuell said. “I think it’s unfortunate, but that’s the way it’s got to be.”

Planned Parenthood of the Texas Capital Region recently released a statement saying the state’s health centers are already “stretched to the max” and that Planned Parenthood provides health care to more than 40,000 Texas women through this program. Peter J. Durkin, president and CEO of Planned Parenthood Gulf Coast, wrote in the statement that Planned Parenthood is prepared to move forward with a lawsuit “if that’s what it takes.”

And such a suit, as stipulated in the bill, would effectively cancel the Women’s Health Program, which, according to a 2011 report (PDF) from the HHSC, enrolled more than 133,000 women in its first 20 months and provided family planning services for 90,080 women.

According to the HHSC handout, more than 215,000 women have been enrolled in WHP at some point.

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