With federal funding choked off, state health officials and Gov. Rick Perry pledge that a Medicaid based program directed at low-income women will live on without federal dollars– but the details on how and what else might be at stake as a result aren’t yet clear.
A rule blocking Planned Parenthood and affiliates of abortion providers from the Women’s Health Program caused Texas to lose its federal funding, as the controversial move violates longstanding national law. Texas now has to scramble to replenish the $35 million the federal government supplied, or 90 percent of the program’s funds, to ensure the state’s neediest women still have access to services like cancer screenings and birth control. Some worry the tab is unrealistic for the beleaguered Texas budget that already saw a two-thirds slice to family planning dollars. The state’s Health and Human Services Commission, however, is reassuring Texans they will, in fact, find the money.
HHSC spokesperson Stephanie Goodman told the Texas Independent that while the figure is, “by no means an insignificant amount,” the commission is confident it can locate the millions needed to sustain the program without further slashing state services.
“One of the things we are not going to cut for this is another service,” said Goodman. “With a budget our size–even with constraints in various areas–there are little pockets of money–$2 million, here and there, that we can pull from.”
Goodman points to project expenditures and contracts that came in under budget, the retirement of old computer systems and money saved from forgone overtime as examples of where the state will extract funds from the commission’s $16 billion annual budget.
In a recent editorial, HHSC Commissioner Tom Suehs confirms the state will continue to provide WHP services even without the federal government’s assistance–but offers little direction on the specifics. He writes:
Many people have asked how quickly we can have a state program up and running. The answer is simple: We already have a state program. The Women’s Health Program receives federal funding, but it’s as Texan as bluebonnets. Texas created the program. Texas state workers process the enrollment applications from women seeking the coverage. Texas operates the system that pays the doctors and providers that perform the services.
While Texas operates the federal-state program, the federal government’s role has been substantial–it provided 90 percent of the money. The state foots the remaining 10 percent.
Others have asked if we’ll still have the capacity to serve Texas women if we exclude abortion providers from the program. The answer is an unequivocal yes. We’ll still have 2,500 doctors and clinics in the program providing care at more than 4,600 sites in Texas. Access to services in rural and remote areas will be much the same as it is today. The vast majority of women won’t have to travel any farther.
Even if the HHSC finds the more than $30 million needed to keep the program going, thousands of Planned Parenthood clients–which make up roughly half of the program’s 130,000 participants annually–will be forced to go elsewhere for basic reproductive care, flooding the pool of available clinics and likely causing overcapacity at smaller sites unequipped to handle increased patient care.
Some remain skeptical that state health officials will come up with a plan that leaves basic services unscathed. Rep. Garnet Coleman (D-Houston), who helped get the Women’s Health Program rolling some five years ago, is one of those unconvinced the funds will be recouped without sacrificing services.
“With the budget shortfall that we already have, I am really concerned about being able to fulfill that promise. I’ll believe it when I see it,” said Coleman. “The majority of the program is paid for by the federal government and we won’t have access to it anymore– so where exactly is that money going to come from?”
Coleman notes the bleak financial landscape surrounding the state’s guarantee to sustain the program–the $74 million in cuts to family planning coupled with the intentional $5 billion in general revenue funds not appropriated to Medicaid last legislative session and a projected $15-$17 billion Medicaid shortfall. And with funding shortages in areas like mental health and HIV treatment in place, health funds are already spread thin, says Coleman. If the money to reinstate WHP existed, he wonders, why haven’t health officials restored other programs in dire need of funding?
“I fear it’s like robbing Peter to pay for Paul. The money we find to pay for it won’t be new money–it will have to be taken away from some other program.”
Now, the representative is fighting to keep the program he helped get off the ground alive by coordinating directly with the federal government. Along with U.S. Rep. Sheila Jackson Lee and state Reps. Sylvester Turner and Carol Alvarado, Coleman is in talks with the federal Health and Human Services Department and the Centers for Medicare and Medicaid to find alternative ways WHP can keep federal funds intact and continue sans denying certain providers. Their efforts yielded a temporary extension of the program earlier this month.
As for a wholly state-run WHP, Coleman vocally worries the end product may be a gutted version, dissimilar in key areas.
“I hope it doesn’t end up as a shell of the program–something called the same but it doesn’t have the same components. They can call it the Women’s Health Program but make the eligibility different. They can choose to cater only to certain subsets of individuals instead of making it available to all women,” said Coleman.