The Defunding of Women's Health Care in Texas May Force Rural Clinics to Close

Categories: Politics

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Which is exactly what will happen in rural Texas.
We keep hammering away at this same general point, but really: It's been a terrible year for family planning providers in Texas. First the Legislature moved $73.6 million out of the state family-planning budget for the next two years . At the same time, they changed to a tiered funding structure that meant clinics that "only" provide family planning services are now third in line to receive what little money is left over, after public community clinics and federally qualified health centers. Then the fight between Texas and the feds over whether Planned Parenthood could legally be barred from the state's Medicaid Women's Health Program ended with the federal government pulling their money from the program, which was 90 percent of the WHP's funding.

The end result? Family planning and women's health services have been cut so deeply it's doubtful they can ever fully recover. Planned Parenthood has been badly hurt, but they're not the only ones. A rural clinic director we spoke to recently is bracing herself for the possibility that she'll have to close all of her family planning clinics for good, a situation many similar community health agencies now face. And with a clientele that's very young and very poor, the director knows exactly what that closing her clinics will mean: "These women just won't be seen. They'll get pregnant or be sick."

Tama Shaw is the director of Hill Country Community Action Association, a rural agency based in San Saba. Community action agencies exist to provide services to very low-income families -- things like child care, elder assistance and help paying for utilities. When we first spoke with Shaw in October, she had just lost 55 percent of the Title XX money she once received from the state. If any more money was lost, she feared all five of the rural family planning clinics HCCAA oversees would have to close. Then the WHP fight happened, and that fear looked a lot more like a reality.

"If there's no money to replace the WHP, we shut down," she says bluntly. Charging the clients more money to make up some of the difference is out of the question. Nearly all of her family planning patients currently pay nothing to be seen, because they're simply too poor: 100 percent below the poverty line or more. "We just couldn't charge our clients enough to stay in business without federal assistance."

Stand-alone family planning clinics like the ones Shaw oversees provide free breast cancer and STD screenings, hemoglobin tests, urinalysis, birth control and HIV testing. They're the most endangered because unlike federally qualified health clinics, they don't get much other federal funding. But that means when clinics like Shaw's are gone, FQHCs and other clinics and hospitals will be suddenly be overrun with patients.

"They won't have the capacity to handle all the women out there who'll need services," Shaw says. "Particularly in our rural area, the local clinics refer their patients to us for family planning."

During the fight over family planning cuts, she testified in front of a state committee and explained that this would be the situation for many rural clinics. "They're just packed full. You sit and wait and wait. It's just going to get worse." She predicts a much higher rate of unwanted pregnancies and STDs, especially given that close to a third of her clients are teenagers. "It's going to be a rude awakening when the state wakes up one day and there are millions and millions of dollars needed to take care of the births to women eligible for Medicaid and they don't have the funds to pay for that."

The other issue is that for some of the areas Hill County Community Action serves, there isn't even a local FQHC. "They'd have to travel and these people can't afford to travel." Even if the patients somehow find a way to travel to the nearest big hospital or FQHC and wait to be seen, they'll now have to pay for birth control out of pocket, Shaw says. That just isn't an option for her patients, despite the myth that there's one type of birth control, and that it always costs $9 at Wal-Mart. "I don't know of hardly any birth control pills that are $9 anymore," Shaw says. "And if you want any kind of permanent birth control, like an IUD, that's a lot more money."

Governor Perry continues to promise that he'll somehow find $34 million or so in the state budget to resurrect the WHP as an entirely Texas-funded (and Planned Parenthood-less) operation. The feds have given the state until April 16 to come up with a plan for that program, as they continue shutting down the federal WHP over the coming months.

Shaw's not putting her faith in Perry's plan, and is instead preparing for the worst. She says her agency has a little bit of money socked away, but would still need to raise a lot of private funds to keep afloat. That doesn't look good either.

"We are out begging for money for our senior program already," she says. "There's no way people in the rural communities are going to see the importance of family planning.
I go around preaching and touting it all the time and I get blank stares. It's kind of the mindset of rural Texas, I think. If you mention those words, abortion pops in everybody's mind. The first thing you have to tell them is we're not related, we don't do that. That's just because of the media. When people hear family planning, they think abortion."


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Addiction treatment texas

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Mister_Mean
Mister_Mean

Time to start taxing the churches.   Time to cut benefits to our state senators and representatives too.   Especially Perry who has run up a multi million dollar debt for his ego trip run for the "Tal-i-ban-Repub-li-can" run for the presidential office (while taking retirement pay on top of his salary as governor).  

Edward
Edward

Anyone who thinks that Governor Perry or our Republican legislators care one whit about poor women (or ANY women at this point!) is living in some kind of alternate reality.

As mentioned previously, even before the hamfisted "we aren't going to fund abortionists anymore even though we aren't funding them now" law was put in place, the legislature and governor slashed women's healthcare funding dramatically, even with billions sitting in a rainy day fund.

The law's supporters said there were hundreds or even thousands of other alternate providers who were going to gladly step in take care of everyone in place of the Planned Parenthood clinics, but that is obviously not the case. 

Just like the failure of abstinence only education, and previous cutbacks on preventative care, the taxpayers of Texas are going to end up on the hook for an INCREASE in costs because of the ignorance of the Republican party. As RTGolden stated in a previous post, the end result of all of this is more pregnancies, more diseases, more poor, uneducated children, more expensive emergency room visits, and on and on. 

It's really hard to comprehend how the members of the so-called "Christian" party can sleep at night, knowing that they are aggressively (and seemingly happily) harming women and children in our state. Sorry, you can't put the blame on President Obama and the feds - these are all results of decisions made by our Republican legislature.

And the rest of us have to live with it.

Semi-Anon
Semi-Anon

F**k 'em. Who cares what a bunch of whiny poor-people say anyway? Until they start donating money to the candidates who can do something about it, the Bob Perry's (no relation), Harold Simmons, and other rich white guys will receive the government they've bought fair and square.

jfpo
jfpo

Finally, an honest conservative!

PlanoDave
PlanoDave

Yeah, because George Soros hasn't donated any money to anybody in government...

Oak Cliff Townie
Oak Cliff Townie

So Lets let Churches ,Charity's  Fraternal Orders and Volunteers pitch in help out with the Rural Woman's Healthcare issues .

 

Rumpunch
Rumpunch

Oak Cliff Townie, I am not sure if you are posting blame or a solution.  However, this is where we need to go.  Some churches have done this, more should.  However, both sides  blame the other for this decline.  The non-church side says that the church has abandoned the poor and the government has had to pick up the slack, while the church blames the non-church side due to seperation of church and state issues and limitations on the deductibility of charitable contributions.

You can look at it as a negative or a positive.  Using your own resources mean being able to do it your way.  Basically, the churches have the resources and the opportunity to do a lot of good.

RTGolden
RTGolden

They've got enough resources to build an $80million renovation of the Compound of Babel in downtown.

Unsparepark
Unsparepark

I thought it would atleast take a few months after Wilonsky for UFP to suck.  I was wrong.

RTGolden
RTGolden

I see wrongdoing on both levels of this argument.  Like so many other issues today, both sides are taking an 'all or nothing' approach to resolving it.The State, gov Perry, et al., will deny healthcare to whomever it takes in order to run Planned Parenthood and their 'abortion factories' out of Texas.The Feds, President Obama, et al., will deny healthcare to whomever it takes in order to keep Planned Parenthood funded in Texas and undermine the religious right.The various disciples, adherents, and acolytes of both sides meanwhile populate blogs with vigorous finger-pointing and blame-laying, carefully keeping their respective halo's balanced atop their respective horns.

The way I see it, compromise would be the way to go.  We had somebody pretty instrumental in shaping our country's early days who advocated compromise as a means of getting to the point of doing the right thing.  Jefferson, I think was his name.  Granted, some of those early compromises were odious, such as counting a person as 3/5 of a citizen without letting those people have even 1/5 of a citizen's rights, but the act of compromising itself is not to blame for the moral failures of the people carrying out the compromise.Back to the present.  Why can't the federal government provide direct funding under the Women's Health Care program to these rural clinics and to Planned Parenthood?  Skip the State, so to speak.  Why can't the State recognize that the Planned Parenthood clinics are separate legal entities from the Planned Parenthood abortion facilities?  The Republicans recognize all sorts of 'legal entities' of corporations when it comes to campaign finance and tax dodges, both of which hurt the state far more than abortion clinics do.It seems very simple to me.  If we defund programs that provide healthcare to the poor, we are shirking our Christian duty to do so.  Any christian who can support this, from either side of the argument, is not much of a christian.  If we do away with family planning, it will cost us more in the long run, as we will invariably pay for WIC, welfare, tuition assistance that the unwanted pregnancies carried to term will incur.  Any conservative who chooses the latter over the former isn't very conservative, fiscally, it would seem.On the flip side, if we let the Feds withold their funds, we're depriving the poor of their much needed assistance, not a very liberal thing to do.In order to do what is right in this case, both sides are going to have to concede something to the other.  The State and the Fed have a choice to make: Do they want to do the right thing, and help the poor, or do they want to make each other look bad and screw the poor.  So far, the poor aren't faring very well.

Rumpunch
Rumpunch

RTGolden, you make a very good point, both sides have lost their ability to compromise. 

Both sides blame the other for playing politics.  They say the other side is pandering to their base (ironically this is generally said in speeches as they are pandering to their own base). 

CNN did a great piece a few months ago about the similaries in rhetoric and political divisions between now and just before the Civil War.  Then and now, both sides believe God is on their side and therefore any compromise is disobedience of God's word.  Both will use "values" as license to push their agenda.

Add money to the mix (i.e. taxes) and you have a powderkeg. 

Branden Helms
Branden Helms

"The State, gov Perry, et al., will deny healthcare to whomever it takes in order to run Planned Parenthood and their 'abortion factories' out of Texas.The Feds, President Obama, et al., will deny healthcare to whomever it takes in order to keep Planned Parenthood funded in Texas and undermine the religious right."That's how the law was written. Discrimination against any provider is against the law passed by congress and signed into law. Bush would have had to decline funding. This is not a R v. D. This is an attempt to trump up conservative credentials to the hard right.

As for directly funding the clinics, that would be a violation of the 10th amendment.

RTGolden
RTGolden

I think you're missing my point.  I understand the Federal government had rules governing how the money can and cannot be doled out to clinics in the state.  I understand that the state is being obtuse in blaming the federal government for cutting off the funds when the state gave it no other recourse.

What I am saying is this.  There has to come a point where people realize that some reaching across the divide will be needed to do what is RIGHT.  Laws make something legal, they don't make it right. Our political system has devolved into a frenzy to BE right, instead of an effort to DO right.  This has to stop.

Keep in mind, the 10th Amendment reserves those powers not granted to the Federal government to the States AND to the People.  The People.  The women who stand to lose in this fight are people.  Above all else, in this country, the government should answer to the people, not use them as pawns in a power struggle.

Brenda Marks
Brenda Marks

This is heartbreaking to read, but not surprising to hear.  Governor Perry, HHS Director Sueh, and all those white, middle-aged-to-senior state Legislators don't care nor understand the necessity for, and lack of, family planning services, and how those services are provided outside of the system of Planned Parenthood Clinics scattered around the state.

Women in Texas of all political persuasions are furious about this and WILL remember in November and beyond.

girlyshirly
girlyshirly

You are exactly right.  What next, they will take away our right to vote because we don't share his personal and religious beliefs.  Women are 2nd class citizens in Texas now.  Think it might be time for me to leave Texas and retire to someplace with rational and sane people governing the state.  And, I'm a native Texan. Hate to think that my daughter and grandchildren could possibly be treated as if we are someone's property and that we have no right to decide for ourselves - if we choose to use birth control or even if we are forced to  make the decision to have an abortion.  No one wants to make that choice, and no one but the person carrying that child should have the right to tell someone what choice they have to make.  It is a personal decision and should remain as such.  Please remember that women resorted to back alley abortions not that many years ago and the Roe v Wade lawsuit supposedly (apparently not really in Texas though ) settled that debate over 30 years ago. 

Mavdog
Mavdog

Only a conservative knucklehead would believe that by denying low income women access to family planning counseling and contraceptives the number of unplanned pregnancies, and the number of abortions, will decline.

The ridiculous laws Perry and his cohorts pushed thru in the name of "right to life" will undoubtedly result in MORE women terminating their unwanted pregnancies (IOW abortions).

Brenda Marks
Brenda Marks

Agreed.  But they could care less about low income women.  And I'm betting they also could care less if those low income women get abortions.  They just won't admit it publicly.

T. Erickson
T. Erickson

First, no DPS office, so you can't get a photo ID to vote. Now this.

Phelps
Phelps

That's why no one cashes checks, drives cars, or buys cigarettes outside the city, right?

T. Erickson
T. Erickson

Usually not one for conspiracy theories, but unless you attend a megachurch, are in a "traditional" marriage and home school your kids, our states leaders seem intent on pushing you aside.

Citizen Kim
Citizen Kim

Why shouldn't they?  They'er already succeeding so well in ethnic cleansing this state of them lib'ral edukated union socialist schoolteachers!  Yeeeeeee Haaaawwww ride'm Perry!

Phelps
Phelps

Why does the White House hate rural women's healthcare?

Diaf
Diaf

Wow Phelps, you are so damn prolific, don't you ever need to check in to work? Or did Obama take your job too? 

Phelps
Phelps

Oh, I get plenty of work in.  People seem to think that these take longer to write than it does.  I don't sit here pondering what to write.  This isn't some epistle written committee.  This is different.  It is called wit.

T. Erickson
T. Erickson

Why don't we stop pointing fingers and provide basic services to people who need them, regardless of what one's personal beliefs may be?

Phelps
Phelps

You mean like... Rick Perry is trying to do?

Bill Lumbergh
Bill Lumbergh

My kind? Creepy guys holding coffee cups saying, "Yeeeeeeeeeeeah," is a kind now? I should start a club.

Moving right along, Rick fucking everything up more is the exact opposite of "least feasilbe damage". So once again, admit you've stuck your foot in your mouth and move on.

Mavdog
Mavdog

are you referring to Kennedy discussing the difference between federal power which is only what is enumerated vs state power which is not?

regardless, the federal government has the right of appropriation, and if it wishes to set parameters on accepting those $ they can.

good luck changing that.

Guest
Guest

I can't imagine what our property tax and sales tax bills would be if we had to fund everything that's currently funded through federal income taxes. More likely, we'd just have bankrupt hospitals and long-term care facilities, along with even more crumbling infrastructure and a bunch of suddenly really desperate poor people who, I'm sure, would simply just cease to exist if they were suddenly completely cut off.

And putting restrictions on money has been found to be Constitutional by numerous courts. If this one suddenly decides that it's not, they'll be ignoring decades of precedent and ignoring the laws duly passed by elected individuals. I thought Conservatives didn't like activist courts?

Phelps
Phelps

No, we are dealing with the fact that your kind made a giant mess, and now it is going to take us some time to clean it up, and until then, we need to keep things going with the least feasible damage to society until then.

Bill Lumbergh
Bill Lumbergh

What a copout response. You defend Rick and then claim the entire system is garbage, yet pretend that still justifies Rick messing it up even more.

Deal with the fact that you stuck your foot in your mouth and move on.

Phelps
Phelps

I was referring to Justice Kennedy's questioning about the constitutionality of transfers to states with strings like this, in that it is coercion from the Feds to the state to enact things that are outside the enumerated powers of the feds -- and therefore, the question is whether or not it is constitutional in the first place.

Mavdog
Mavdog

Preventive care is "wasteful"??? I'd suggest you take a moment and read about how the preventive care these clinics provide save $ in the long term. The provision of contraception itself saves $100's of millions.

Mavdog
Mavdog

In this case, the TX legislature seems to believe that it is better to not give the funds for health services, and therefore not provide healthcare to the lowest income citizens, than to dip into the monies they already have (see "rainy day fund") or to raise a tax to get the funds. So no, because our state legislature is full of dimwitted ideologues there would not be any money available if te feds didn't give it to the state.

As for the ridiculous attempt to insert the Affordable Care Act into this discussion, the mandate for the patient, not the state, to determine the health care professional predates Obama. Also, the ACA doesn't really get implemented for almost 2 years so that in itself shows how absurd your comment is.

Phelps
Phelps

Trick question.

The system didn't work.  It's never worked.  It has always been wasteful.

Bill Lumbergh
Bill Lumbergh

Mind explaining how it being THE PEOPLE'S MONEY changes the fact that Rick is just monkeying with a system that worked?

You seem to forget what the actual topic at hand here is: Perry's creating more gov't inefficiency because he just can't let the federal gov't have all the fun...er, control.

Phelps
Phelps

Why are the feds taking the money just to give it right back to the states?  Why not just stop taking it, and if the states need the money, they can raise it however?

It's coercion, and since it is wrapped up in the Obamacare case, the SCOTUS might finally get around to recognizing that it is unconstitutional.

Guest
Guest

Making sure states follow the law is important.

What's to say that the Governor would spend anything on women's health care, or health care at all, if everything from the Feds became just a giant blank check that could be spent on anything without restriction? It's not like Governor Perry and the legislature hasn't spent money on things other than the official purpose when legal restrictions weren't in place. It's how we've ended up with a balanced budget in some prior years.

Phelps
Phelps

The money came from THE PEOPLE.  You clowns seem to forget that.

Bill Lumbergh
Bill Lumbergh

When that money is coming from an entity that already gave you the rules on how to spend the money, you're damn right it is overreaching.

Phelps
Phelps

Wait, I thought the argument was that we never did get away from only the wealthy and powerful benefiting.

You guys really need to get on the same page.  And by you guys, I mean the voices in your head.

Phelps
Phelps

Right, because the government restricting how it spends money is "overreaching."

Bill Lumbergh
Bill Lumbergh

If Rick was trying to do that, he would have left the system alone instead of "regulating" it with more bullshit that only restricts choices.

For a man that whines about gov't overreaching itself, he's a prime example of the problem itself.

Mavdog
Mavdog

so in your opinion everyone should kowtow to Perry and his cohort's extremism and discriminatory views?

Giving in to a boneheaded and destructive policy is not a path that will prove positive for our state's future.

Just say no to ignorance....

T. Erickson
T. Erickson

There is a long history of providing basic services (health, education, roads, infrastructure) to residents of the state, along with safety guidelines for the air, water and food. Some, (and I include Perry in this group) seem intent on returning to an early 20th century version of this, where only the wealthy and powerful benefited from this and others suffered simply because of their social status.

T. Erickson
T. Erickson

He's doing a great job of looking bad all on his own. I fail to see how these moves are a benefit to low-income Texans. Unless you are intent on wishing them away.

Phelps
Phelps

You're right.  Fuck these women -- making sure Rick Perry looks bad is more important.

T. Erickson
T. Erickson

Gov. Perry is trying to curry political favor in exchange for the health of Texans. He's also going to cost the state more when people turn to urgent care centers and emergency rooms to receive services previously available in clinics.

Mavdog
Mavdog

No, like the federal regulations call for, which is completely opposite from the politicalized Texas law Perry and his fellow Repubs pushed thru.

Why does Rick Perry want to stop low income Texans from getting health services?

Guest
Guest

Why do the governor and the legislature hate the law?

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