Commentary: Texas Legislature leaves women’s health services in pieces

This is the story of a veto.

Though there were 50 bills rejected by Gov. Greg Abbott following the 85th legislative session — each with its own narrative — this tale is about Senate Bill 790, which would have extended for two more years the work of the Women’s Health Advisory Committee, a group of providers who advised the state regarding the organizational and funding structures of the new women’s health programs in Texas.

Once upon a time, when more reason prevailed, Texas lawmakers created a Medicaid waiver program to provide basic health screenings and contraceptives to women who would not otherwise have these covered by insurance. And this Women’s Health Program was so successful in preventing unplanned pregnancies and saving taxpayer dollars that, after analyzing a few years of data, the Legislative Budget Board recommended an expansion to reap even greater benefits. Disappointingly, by that time, the era of reason — relatively speaking — had come to an end.

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In 2011, the “war on abortion” was in high gear. Many Republican lawmakers equated family planning clinics such as Planned Parenthood with that single medical procedure. Unfortunately for the Women’s Health Program, it turned out that the big bad Planned Parenthood was the program’s largest provider, serving nearly half of its clients. When the organization became a target, so did overall family planning services throughout the state.

Thus, against its own self-interest, the Legislature huffed and puffed and blew down the house of the Women’s Health Program while also cutting family planning funding by two-thirds. This gravely impacted access to services across Texas and forced over 80 clinics — most of which were not Planned Parenthood facilities — to close their doors.

When legislators returned in 2013, sobered from the headiness of winning that first battle, many were stunned to learn of the collateral damage and that their actions impacted more than just a single targeted provider. Donning their white knight duds, they rode to the “rescue” with program changes and increased funding, while still, of course, banishing Planned Parenthood. However, as in the story of Humpty Dumpty, a severely tattered safety net system could not easily be put back together again.

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Despite the Legislature’s attempt to mend the self-inflicted wounds, women’s health was still in jeopardy. A new state-funded replacement for the Women’s Health Program was seeing significantly fewer clients than the original program, even after a major uptick in provider enrollment. The much-heralded funding boost did not actually restore but, rather, redirected revenue toward another new program, which also failed to meet its family planning service goals. Once again, women’s health programs faced a significant overhaul.

The last chapter of our story begins with the consolidation of women’s health programs in 2015. As this was the third attempt to rebuild a once-successful program, it was critical that the third time be the charm. Hence the creation of the Women’s Health Advisory Committee to help ensure that the system would efficiently and effectively target eligible populations with a seamless and comprehensive array of services, including family planning.

The new Healthy Texas Women program was not fully implemented until the summer of 2016, and sadly, the most recent data revealed that the state continues to see fewer women than before. With the jury still out on the success of the consolidation, a coalition made up of health professionals, advocacy groups and a bipartisan assortment of lawmakers successfully passed SB 790 to extend the Women’s Health Advisory Committee for another two years.

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No oracle predicted the final outcome: SB 790 was felled by a veto pen against the better judgment of those most connected to the topic. Today, women’s health services limp along, trying desperately to recapture a level of effectiveness that was lost due to legislative meddling in 2011 — and without boots-on-the-ground folks to help ensure proper outcomes.

The moral to our story? Perhaps, “If it ain’t broke, don’t fix it.” After all the changes to the state’s women’s health programs, we are still trying to merely achieve service levels from days of yore. For now, though, women and their families seem to be trapped in one of Grimm’s fairy tales, waiting for a hero to ride in and save the day.

Howard has served in the Texas Legislature since 2006, representing House District 48 in Travis County.

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