Archive for the ‘Texas Reproductive Rights’ Category

Texas lawmaker seeks to reverse Planned Parenthood ban

Posted on: November 16th, 2012 by Mary Tuma 6 Comments

A Texas lawmaker introduced legislation earlier this week that would nullify a controversial rule banning abortion affiliates from participating in a Medicaid program that offers reproductive health care to low-income women. (more…)

‘Why are they making this more difficult for us?’

Posted on: October 29th, 2012 by Mary Tuma 4 Comments

Crystal Gonzalez sits in a McAllen, Texas, coffee shop while searching for a new health care provider. Photo by Mary Tuma.

When Texas decided to exclude Planned Parenthood clinics from its Medicaid-funded women’s health care program, women like Crystal Gonzalez were left scrambling for a new provider. (more…)

STUDY: Family planning cuts in Texas force clinic closures

Posted on: September 27th, 2012 by Mary Tuma 5 Comments

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Deep slashes to family planning funds made during Texas’ last legislative session have caused 53 clinics that provide family planning services to shutter their doors, according to a new article in the New England Journal of Medicine.

Additionally, 38 clinics reduced their hours, and many of the existing clinics have been forced to lay off staff and cut back basic services as a result of “the most radical” legislative effort to curb reproductive health funding in the nation, the study finds. (more…)

Citing “important precedent” neglected by state officials, three judge panel temporarily reinstates Planned Parenthood in WHP

Posted on: May 8th, 2012 by Mary Tuma 3 Comments

After a tumultuous week for the fate of reproductive care in Texas, Planned Parenthood will remain in the Women’s Health Program (WHP)– at least for now.

Just hours after an initial federal court ruling last Monday that deemed Texas’ controversial decision to block the centers from the WHP unconstitutional, a single judge quickly reversed the temporary injunction in a move being called “very rare” and “highly unusual.” The legal battle took another twist two days later when a three-judge appeals panel struck that order down and reinstated Planned Parenthood into the program, pending oral arguments and eventually a full trial.

In its May 4 briefing, the Fifth Circuit Court of Appeals panel–which includes the judge who granted the state’s emergency stay–slammed Texas for continually omitting “important precedent” in its attempt to enforce the ban. While the state is fighting to keep Planned Parenthood from participating in the federally subsidized low-income reproductive health services program because it provides abortions, the panel noted a significant 2007 Fifth Circuit case that makes clear Planned Parenthood abortion services operate as wholly separate operations from family planning services and is thus able to receive public funding– a case never mentioned by Texas officials in their court proceedings.

Our conclusion rests in part on the state’s continuing reluctance to address the obviously relevant opinion in [Planned Parenthood of Central Texas vs Sanchez]. Despite the plaintiffs’ and the district court’s having relied extensively on that authority, which binds this panel to the extent it is applicable, the state never mentioned it (as far as we can tell from the record) in the district court and did not refer to it in any way in its motion for stay pending appeal. Nor has the state sought leave to supplement its submission with a response to Sanchez the plaintiffs’ focus on the affidavit referred to above.

Blake Rocap, legislative counsel with reproductive rights advocacy group NARAL Pro-Choice Texas says the state’s refusal to take Sanchez into account is significant and ushers in further criticism that the legal battle is fueled by ideology rather than concern for women’s health.

“The three-judge panel commented on the Attorney General’s failure to address this specific and relevant precedent in their briefing– another indication that this is not about upholding law or women’s access to health care but is much more about politics,” said Rocap.

Echoing plaintiff concerns, the panel also called into question the state’s need for an emergency stay to reverse the initial court ruling. Requested by Attorney General Greg Abbott, the stay was granted within 24 hours by Judge Jerry Smith, a former GOP county chair and Republican activist with a controversial history of disparaging women, the Texas Independent previously reported. The urgency of the stay relied on the claim that preventing the ban would force Texas to cease operating the WHP  “upon termination of federal funding.” But funding will continue until November 2012, the briefing points out, invalidating the state’s argument.

This supplemental filing undermines the State’s assertion of irreparable harm if the injunction is not stayed pending appeal. Regarding the balance of the merits, we cannot conclude, on the present state of the record, that the State has shown a great likelihood, approaching a near certainty, that the district court abused its discretion in entering the injunction.

An ‘emergency stay’ is normally reserved for situations that would cause irreparable harm, says Wayne Krause-Wang, legal director with the Texas Civil Rights Project. The cases must qualify as exceptional circumstances with severe time constraints– the state’s claim for such an emergency is questionable, he argues, considering its lack of proof of damage.

“It was certainly a tactic within the ability of the state of Texas to pursue,” said Krause-Wang. “It makes sense to apply for an emergency stay if you have the evidence to back it up, in this case it didn’t appear the state had the evidence, and that’s what the three judge panel ended up ruling at the end.”

“In retrospect the state’s argument of irreparable harm doesn’t seem to be viable. Ironically, it is a little disingenuous to say the state would be harmed by their own voluntary decision to cut off the Women’s Health Program, I think that’s turning the argument on its head,” he added.

Rocap called the emergency order “especially duplicitous.”

“Planned Parenthood has served as the largest provider of these services in the WHP since 2005 without incident, yet these anti-choice politicians are now declaring that it is an “Emergency” to exclude them because they exercise their First Amendment rights to affiliate with advocates of safe legal abortion,”  he said. “Given no injury has been shown over the past seven years of Planned Parenthood’s participation, it is clear that the true emergency is that this is an election year and again we are seeing politicians put the health of their political careers ahead of the health of women.”

The Health and Human Services Commission (HHSC), which days earlier indicated it would shut out Planned Parenthood, is now prohibited from enforcing the ban. The district court will decide on a definitive trial start date on May 18. The Fifth Circuit Court of Appeals will hear oral arguments on the state’s appeal of the temporary injunction during the week of June 4.

“We will comply with the court’s order as the case proceeds,” said HHSC spokesperson Stephanie Goodman. “We also will continue to work toward a state program that provides women with access to vital family planning services and complies with the law that bans abortion providers from getting those funds.”

Read the court of appeals document here.

(Photo Source: Flickr/WeNews)

Judge with history of disparaging women stays state appeal to exclude Planned Parenthood from WHP

Posted on: May 1st, 2012 by Mary Tuma 3 Comments

A court ruling issued yesterday that would have stopped Texas from implementing a ban on Planned Parenthood providers in the Women’s Health Program (WHP) is now obsolete. The state quickly appealed the ruling just hours after it was announced and received a stay on the preliminary injunction the same day, giving reproductive rights advocates less than 24 hours to celebrate. Texas is now able to exclude Planned Parenthood from the life-saving WHP, shutting out tens of thousands of low-income women who rely on the clinics for basic reproductive health care.

“The ruling allows the state to fully enforce state law today and exclude abortion providers from the Women’s Health Program. As of today, abortion providers and affiliates aren’t eligible to bill the state for Women’s Health Program services,” said Health and Human Services Commissioner (HHSC) spokesperson Stephanie Goodman in an e-mail.

Yesterday’s ruling concluded that Texas’ ban on allowing Planned Parenthood providers to participate in the WHP because they affiliate with abortion services would pose “substantial and irreparable harm,” to hundreds of thousands of low-income women. It violates the provider’s First Amendment rights and ultimately fails to serve the public interest, Bush-appointed Judge Lee Yeakel ruled. In response, Attorney General Greg Abbott writes in the appeal that the state and the women of Texas who depend on the WHP would be, “irreparably harmed” because state law prohibits Texas from continuing to operate the program, “if taxpayer money must be provided to entities that affiliate with abortion-promoting entities,”–  despite the fact no taxpayer money is allowed to go toward abortions and no clinic in the program actually provide abortion services.

The appeal takes sharp aim at blaming Planned Parenthood for its response. “Consequently, the district court’s preliminary injunction effectively forces Texas to choose between contravening state law and shutting down the program,” Abbott writes. “This emergency situation is of Planned Parenthood’s own making. Planned Parenthood has been on notice of the state law at the heart of this suit for months.” Similarly, Texas has been on notice by the Centers for Medicare and Medicaid which warned the state it would lose all federal funding if the rule excluding Planned Parenthood– a provider of the program since its inception some five years ago– goes into effect, but the state remained steadfast in arguing its right to exclude the clinics, in the face of federal law.

Sarah Wheat, interim CEO of Planned Parenthood Austin, is confident Yeakel’s ruling will hold if the issue sees a full trial. (A May 18 pretrial conference date to decide when a full trial will begin is scheduled, but that may change as events evolve.)

“We are disappointed in the stay granted last night, but we will be responding [later] today. We are optimistic that when the State’s motion for a stay is fully considered, the District Court’s order that Texas cannot prevent Planned Parenthood from providing cancer screenings, birth control, screenings for high blood pressure and diabetes, and STD testing as part of the Women’s Health Program will stand,” she said in a statement. “When presented with both sides, the District Court agreed the rule was likely unconstitutional, and that implementation would cause a serious problem with health care access for Texas women.”

On behalf of HHSC Commissioner Tom Suehs, Abbott filed the emergency motion to stay Monday evening in the U.S. Fifth Circuit Court of Appeals. Judge Jerry Smith– a former Harris County GOP chairman, Republican activist and oil-industry lawyer, appointed to the bench by former President Ronald Reagan– granted the stay. While an April Associated Press article describes Smith as a non-partisan figure, the judge came under fire for “disparaging comments” he reportedly made about women during his time as GOP county chairman.

A July 1987 article in the Houston Chronicle says Smith had labeled feminists as a “gaggle of outcasts, misfits and rejects” [with "perverted views”] and referred to the League of Women Voters as the “Plague of Women Voters.”

Upon retrieval of the 1987 article, The Texas Independent additionally notes Smith is also reported to have made attempts to, “get a black woman judge removed from a minority rights case.” Combined with his criticism of women, civil rights and feminist organizations “immediately questioned or spoke out against” his nomination to the 5th U.S. Circuit Court of Appeals. Linda Berg, counsel for the national office of NOW told the Houston Chronicle at the time, “He clearly is very insensitive, at least in the past he has shown himself insensitive, to minority rights and women’s rights. He has been involved in some controversial actions that upset women’s and civil rights groups in Houston.”

In January, Smith was part of the three-judge panel that upheld Texas’ controversial pre-abortion sonogram law, a move that overturned a U.S. district judge’s ruling that found the law unconstitutional. Basing the decision largely on moral grounds, Smith helped strike a preliminary injunction on the sonogram law, a ruling heralded by Gov. Rick Perry and state anti-abortion advocates. Undergoing an abortion is “a difficult and painful moral decision,” the judges concluded at the time, “While we find no reliable data to measure the phenomenon, it seems unexceptionable to conclude that some women come to regret their choice to abort the infant life they once created and sustained. Severe depression and loss of esteem can follow.”

According to a 1996 Austin American-Statesman article retrieved via Lexis-Nexis, Smith dismissed a damage suit by a Texas mother who sued school officials in Bryan for not protecting her two middle-school age daughters from sexual harassment by boys on the school bus. The girls allegedly, “had endured nine months of repeated taunts, groping and grabbing,” while riding the bus. ”The mere existence of sexual harassment does not necessarily constitute sexual discrimination,” the Judge wrote for the Fifth Circuit Court.

Planned Parenthood is expected to file a brief later today. To read a copy of the state’s stay request, click here.

Hours after federal judge blocks Texas’ Planned Parenthood ban, state files appeal

Posted on: May 1st, 2012 by Mary Tuma No Comments

Just hours after a federal judge ruled against Texas’ controversial decision to bar Planned Parenthood clinics from the vital Medicaid-based Women’s Health Program (WHP), Texas officials were quick to call for an appeal of the temporary injunction, adding another hurdle in the ongoing tug of war over basic reproductive health care.

Planned Parenthood affiliates filed suit in early April to contest the state’s enforcement of a rule prohibiting the clinics from taking part in the WHP because they provide abortions, despite the fact abortion services are not paid for by WHP and can’t legally be subsidized by federal or state funds. The suit challenges the state’s decision as “unconstitutional” under the First and Fourteenth Amendments and argues that women should be allowed to choose their health care provider without state interference. It also claims that the Health and Human Services Commission’s (HHSC) regulation violates Texas law, as it conflicts with the intention of the statutes that created the program.

In his Monday ruling, U.S. District Judge Lee Yeakel – appointed to the bench by George W. Bush in 2003– found that Texas is not allowed to exclude the centers from the federal program, as they collectively provide a “critical component” of the WHP. Doing so would likely be unconstitutional, Yeakel argued, since Texas is basing Planned Parenthood’s participation in the program on their abortion affiliation, services which are maintained as financially and legally separate and are constitutionally protected operations.

Shutting nearly 50 Planned Parenthood centers out of the WHP– a program that provides basic reproductive health care like birth control, cervical cancer and STD screenings to uninsured low-income women– would cause “substantial and irreparable harm” as clinics would be forced to close, lay off staff and reduce operating budgets, wrote Yeakel. And the damage isn’t limited to WHP patients, he wrote– if clinics are forced to close their doors or reduce hours, tens of thousands of other clients would be turned away, as well.

The exclusion would result in a “significant reduction in funding family-planning services” and deprive hundreds of thousands of women basic access to health care, especially in rural areas, the court noted, pointing to already beleaguered clinics in North and West Texas, Lubbock and Hidalgo County. The assurance by state health officials that they will find replacement providers for displaced rural women who rely on Planned Parenthood–an issue previously reported on by the Texas Independent–came under scrutiny by the judge.

“The court is unconvinced that Texas will be able to find substitute providers for these women in the immediate future, despite its stated intention to do so,” wrote Yeakel.

It is in the public interest to allow Planned Parenthood providers to continue their services within the WHP, he found.  The judge also expressed little faith in Texas’ ability to recoup the $35-40 million in federal funds lost due to its decision to cut Planned Parenthood out of the mix of providers.

“Although the Governor has instructed that the program is to continue fully funded by Texas, the current record gives the court no comfort that funds are or will be available to continue the program after the phase out of federal funds,” Yeakel wrote in his conclusion.

Patricio Gonzales, who heads Planned Parenthood Association of Hidalgo County– a poverty-stricken border area hit hard by budget cuts and bracing for additional slashes– called on Governor Rick Perry and the state to prioritize women and “set aside any vendetta they may have against Planned Parenthood.”

“No woman should ever have to fear being cut off from her doctor’s care because of shortsighted political games,” said Gonzales in a statement. “Legal action is always a last resort, but the state and Governor Perry’s actions gave us no other option. The health and well-being of our patients is our number-one priority. We hope that this decision will allow us to continue our lifesaving work of providing high-quality health care and cancer screenings to some of Texas’ most vulnerable women.”

In his concluding remarks, Yeakel stressed the ruling was not definite. A “thorough airing of the issue by trial” remains necessary. If the federal funds are phased out and Texas fails to salvage the program, the judge admitted the ruling “may be of no consequence.” A conference date to determine when the full trial will begin is scheduled for May 18.

Not wasting any time, Texas Attorney General Greg Abbott on behalf of HHSC Commissioner Tom Suehs responded by issuing an appeal in the hours following the ruling.

How Gov. Perry and state health officials will create a wholly Texas-run WHP program and come up with the millions in federal funds forgone because of their decision, and whether the program will continue at all are equally questionable at this point. Some fear the state will dismantle the program, as officials have publicly vowed to do if Planned Parenthood won the suit, according to the San Antonio Express-News earlier this month. HHSC says it will follow the ruling for now, but seems determined to stick by what officials view as a state’s rights issue.

“We received the judge’s order and will comply with the ruling, but we remain confident that federal law gives states the right to establish criteria for Medicaid providers,” said HHSC spokesperson Stephanie Goodman in an e-mail response.

When asked if cutting the life-saving Medicaid program altogether was still an option on the table now that the temporary injunction has been granted, Goodman said the department is in talks with the AG’s office to determine their next steps.

“We’ll need to carefully review the ruling and consult with the Attorney General’s Office before we make any decisions on the program’s future. One of things we’ll be looking at is whether the judge’s ruling allows for the creation of a state-funded program that excludes abortion providers and affiliates,” she said. “We remain committed to ensuring that the program ultimately complies with state law.”

In a statement released after the ruling, Perry spokesperson Catherine Frazier responded similarly.

“Texas has a long history of protecting life, and we are confident in Attorney General Abbott’s appeal to defend the will of Texans and our state law, which prohibits taxpayer funds from supporting abortion providers and affiliates in the Women’s Health Program,” she said. “We will continue to work with the Attorney General to pursue all available legal options.”

Perry and state officials argue their ability to block Planned Parenthood from the program is constitutionally sound under state law and have attacked the Obama administration’s “pro-abortion agenda” for disallowing their rule, despite a comparable block by the health administration under former President Bush, the Texas Independent reported. The ban is said to run counter to federal Social Security law and is therefore prohibited.

Planned Parenthood says it is keeping an eye on the state’s next move. For them, Texas’ speedy appeal is a sign that the fight is far from over.

“The state has given us every indication that they would end the program entirely,” said Planned Parenthood representative Erica Prosser. “We are waiting and watching to see what they do next.”

A copy of the preliminary injunction ruling can be read here. A copy of the state’s appeal can be read here.

(Photo Source: Flickr/WeNews)

Amid state funding plan, doubt over displaced WHP client care remains

Posted on: April 24th, 2012 by Mary Tuma 3 Comments

In the ongoing volley between state health officials and the federal government over funding the Women’s Health Program (WHP), Texas laid out its plans last week to wholly take over the Medicaid program by November. Unwilling to allow abortion affiliates into the WHP, Texas lost out on 90 percent of its funding from the Centers for Medicaid and Medicare (CMS) since the exclusion is said to run counter to federal law.

Sticking to what they see as their constitutional right to ban abortion providers from the program, the state is now prepared to create its own strategy to continue WHP– one that will shut out a major provider of the low-income care program and likely strain an already fragile network of family planning centers.

While the state’s plan to recoup the $30-$40 million in lost funding assumes those dollars will be found without cutting other services, another gap remains to be addressed. By nixing Planned Parenthood– centers that see about 46 percent of WHP clients or 130,000 women annually– the state’s plan forgoes subsidizing the single largest provider of basic reproductive care within the program. That rift is casting severe doubt from heads of Texas family planning centers over whether or not remaining providers have the resources to see and treat former Planned Parenthood clients.

The state’s health commission says it is taking proactive steps to ensure those Planned Parenthood patients find access to other providers during what they anticipate as a “seamless transition” to a state-run program.

“We are working on resources to help those women find new providers,” said HHSC spokesperson Stephanie Goodman. “We have a phone number posted on our website and we are building an online database for clients to look up the closest provider.”

HHSC is encouraging new providers to enroll in the WHP and asking existing providers to take on more clients. Goodman says discussions with large family planning clinics and individual OB/GYNs in the state which are able to comply with the rule and have the space to see new clients have been fruitful. Many of the 2,500 providers are not operating at full capacity, said Goodman.

However, that may not necessarily mean those clinics are able to handle the increased clientele caused by displaced Planned Parenthood patients– especially in rural areas, state family planning leaders say.

Tama Shaw, executive director of rural-based Hill Country Community Association (HCCA) and president of Women’s Health and Family Planning Association of Texas (WHFPT), a network of reproductive health providers rooted in assisting more than 800,000 low-income women, says the space is just not there. After WHP cuts hit a Planned Parenthood center in Waco, clients started filtering to one of the Hill Country clinics north of the city. But “by no means” would the clinic have the capacity to take care of all its patients, she said.

As a possible alternative to those WHP clients originally served by Planned Parenthood, HCCA itself is spread thin. Not immune from the recent and deep slices to the state’s reproductive health funding, the network was forced to shutter five out of nine clinics after legislative budget cuts slashed Title X federal funds and placed the family planning clinics on the lowest tier of Title X funding, behind federally qualified health care providers (FQHC) and public community clinics. Today, HCCA relies on a temporary three-month extension for federal funds; without it they could be completely abolished. After 40 years in existence, Shaw’s network for low-income women has been shredded– right now, she says, they are “hanging in there.”

Kathryn Hearn, community services director at Planned Parenthood Association of Hidalgo County echoes Shaw’s concerns. About 80 percent of WHP participants in the border area come to Planned Parenthood, solidifying it as the largest provider of the program in the region– the next largest serves less than 500 people, she said. Treating some of the state and country’s poorest women, the association will have to turn away 6,500 patients if the WHP shuts down. There is simply no way surrounding clinics can integrate that number of patients, says Hearn.

“Of course there are other providers in this community for these women but we are already hearing– publicly and privately­– from so many of them that they cannot absorb this many patients into their clinics or private practices,” she said. “It’s a big problem.”

Many of the association’s patients rely on the WHP and Planned Parenthood as their sole care provider for preventative health. Travel time to other clinics in the surrounding areas would likely be a strain on low-income women in terms of transportation costs and time off work traveling. Without WHP they might end up in the emergency room, forced to pay out of pocket, said Hearn.

“We have spoken to women all over the county. We receive calls daily from women concerned about not only losing their health care but being forced to go somewhere other than Planned Parenthood. They’ve chosen to come to us as a trusted provider of choice, now they are scared,” said Hearn.

With an already beleaguered health care landscape– from FQHC and free-standing clinics to hospital districts– the idea that non-Planned Parenthood centers can absorb the additional patients is not feasible, says Fran Hagerty, executive director of WHFPT. In 2011, there were 72 women’s health care contract providers in the state, now there are 42.

“The clinics cannot even take care of the number of patients they served last year, much less new patients. Nobody is in a position to take on hundreds, let alone thousands of new clients. Everyone is at capacity,” said Hagerty. “What we are seeing are clinics defunded, going out of business and scaled way back in operations, that is if they are still viable. And so they are not able to take any more patients on.”

Health care leaders remain doubtful about the state’s reassurance that family planning centers and individual OB/GYNs can offset the loss of Planned Parenthood services. Time-consuming paperwork, low reimbursement rates, overburdened staff and long wait times make taking on WHP clients difficult for rural clinics and private doctors, says Shaw.

“Those on the front lines providing the services and treating the women know that it’s not true. Logic would have it that it’s not true– I think the rest is just rhetoric,” said Shaw, who testified during a Texas Senate committee hearing about the constraints rural clinics and patients face and the consequences of a deteriorated family planning network, including increased pregnancy and STD rates. “The rural capacity is not there and relying on individual physicians isn’t going to work. Where are these women going to go?”

Hearn reiterates the point that the Medicaid program is difficult to manage. “Many of these clinics just won’t find it cost-effective to absorb these additional patients,” she said.

Hagerty says she is in talks with HHSC to argue the capacity to treat WHP patients is not present. “I hope they are prepared for the reality of what’s coming– a situation in which women don’t have anywhere to go for health care.”

Hagerty and Shaw say the cuts will result in increased rates of STDs, abortions and Medicaid paid births– one of the central reasons WHP was created. According to a 2011 Legislative Budget Board estimation, the program would save the state $3.8 million in general revenue funds in preventative pregnancy-related costs over the next two years.

“It’s going to be a rude awakening when Texas ends up with a lot of low-income pregnant teenagers,” said Shaw.

CMS officials say they are still reviewing Texas’ extension plan. If they agree, the state will run the WHP beginning on Oct. 31, giving the feds five months to agree to continue funding the program. Whether or not CMS will agree is unclear at this point.

“We formally received their transition plan proposal yesterday and are considering the implications of the longer enrollment period,” said CMS spokesperson Alper Ozinal in an e-mail. “We will be working with the State to reach a mutually agreeable transition plan that complies with the law while protecting beneficiaries

(Photo Source: Flickr/WeNews)

Proposed abortion reporting rule meant to ‘intimidate’ physicians, say critics

Posted on: April 18th, 2012 by Mary Tuma No Comments

A proposed requirement by the state’s health services department would force doctors to collect detailed information about Texas women who seek abortions. Initially drawn up by Republican Rep. Bill Zedler during the 82nd legislative session, the new requirements would expand the scope of what a doctor must report to the state when performing an abortion. While health officials say the rules are important for demographic reasons, some pro-choice advocates and OB/GYNs argue the additional reports only serve to create a burdensome and intimidating climate for abortion-providing physicians.

Currently, doctors must disclose to the state information about the patient’s marital status, race, age and number of prior abortions and births. The “updated” requirements add data like the woman’s highest level of education, how she verified the pregnancy, the date of her last menstrual cycle, whether or not the woman viewed printed health materials (such as the controversial “Woman’s Right to Know” pamphlet) prior to the abortion and whether the ultrasound image of the fetus, a description of the image and an audible heartbeat were made available by the doctor.

Zedler’s original legislation, HB 1602, would have required the collection of even more granular details. The information was desired to maintain enough statistical data to, “aid in providing proper maternal health assistance, regulation, and education,” for women, according to the bill text. Zedler called for data on the age of the unborn child’s father, the method of contraception used that led to the pregnancy, why the woman chose to have an abortion (in checklist form), the number of miscarriages the woman has undergone and specific information regarding the woman’s educational background, among other particulars. The representative did not return calls for comment.

Zedler’s bill didn’t make it through a GOP super majority House last session, but is seeing new life through the Department of State Health Services (DSHS)–a move drawing criticism from abortion providers and pro-choice advocates who see the maneuver as both intrusive and a bypass of the legislative process, reproductive rights news site RH Reality Check recently reported.

During a DSHS stakeholder meeting earlier this month, the point of most concern among the groups was a requirement that forces doctors to report any complications caused by the procedure within 20 days. Since abortion facilities are already required to report such complications to the state department, meeting attendees called the new rule, “redundant and potentially intimidating.”

Dr. Curtis Boyd, a Texas-based abortion provider and OB/GYN, echoed these concerns. Boyd told the Texas Independent the proposed rule was not only repetitive but would exacerbate an increasingly hostile environment for the state’s abortion providers and their patients. While current requirements mandate facilities report information, the new rule would target individual, private-care doctors likely unfamiliar with the reporting process.

“This is going to discourage doctors from providing abortion services,” said Boyd. “There will be a fear that they may be identified and open to harassment, or penalized for not reporting certain information. Why aren’t they asking for additional reporting in other specialties? This is not about public health or patient health, this is about ensuring one legislator’s anti-abortion agenda is pushed through.”

Boyd pointed to the state’s recently enacted sonogram law–a requirement that forces abortion providers to show and describe the heartbeat of the fetus before the procedure–as evidence this new rule is just one more attempt to intimidate abortion physicians. Failure to comply with the law can result in criminal charges, a hefty fine and revocation of medical licenses. There is no warning, no caution, no inspection–the punishment is meant to intimidate the doctor, said Boyd.

“Like the sonogram law we’ve been dealing with as physicians, these rules are another way to shame and guilt women and their doctors,” he said. “It’s disrespectful to women. There is no doubt this is anti-abortion, anti-birth control and anti-woman.”

The most “disturbing” aspect, says Boyd, is that after failing to cull enough support during session, the bill language managed to evade the legislative process and debate and be sent directly to the state’s health department for rulemaking.

“Clearly this legislator has his own anti-abortion agenda and instead of using the democratic process he has gone around to the state and asked for a pass,” said Boyd. “Is this going to lead to other legislators pushing bills without going through the process?”

But Department of Health and Human Services (DSHS) spokesperson Carrie Williams said the course of action isn’t abnormal. During special session, the DSHS, along with the Health and Human Services Commission agreed to look at Zedler’s proposed additional requirements and figure out if they could possibly adopt some of those elements by rule, she said.

“It’s common for us to take stakeholder and legislative input at any point in time,” said Williams. “We are always in the rule writing process. We are required by law to make sure our rules are evolving and regulating the best interest of patients. Our goal is to make improvements based on public health expertise and regulatory function.”

As for concern over making sensitive patient information available for public view, the DSHS says the law is highly restrictive about what information can be provided. For instance, while data may be viewable online, the identity of the doctor, facility and patient is kept confidential.

Drafted language of the proposed rule was presented earlier this month. DSHS plans to present the final copy of the updated requirements to its decision-making committee on June 14. Williams says the new rule is a work in progress and the department is in the process of collecting feedback and taking comments under consideration. “It’s a launching off point. We are open for discussion and can make adjustments as we move forward,” she said.

(Sonogram image: CreativeCommons/checkstaticlines)