By Janet Realini, M.D., M.P.H.
Chair, Texas Women’s Healthcare Coalition
In a bipartisan effort, the 83rd Texas Legislature increased funding for preventive care for low-income women, making an important first step toward restored access for over 140,000 low-income women. Senate Bill 1, now signed into law by Gov. Rick Perry, invests in family planning in three key funding streams.
- It adds $32.1 million in state funding to the Department of State Health Services Family Planning Program, replacing federal dollars awarded to the private Women’s Health and Family Planning Association of Texas network through Title X;
- It adds $100 million for a DSHS Primary Health Care Expansion for women’s health care, 60 percent of which will provide contraceptive care; and
- It adds $71.3 million in state funding to maintain the Texas Women’s Health Program, which lost its federal funding due to the “Affiliate Ban Rule” that excluded Planned Parenthood from the program.
This legislation will mean that subsidized family planning in Texas can offer access to approximately the same number of women in 2014-15 as in 2010-11, before the deep cuts of 2011.
Texas’ safety net for women’s health care was reeling after the severe cuts to family planning instituted in 2011 by the 82nd Legislature. The $73 million cut to the DSHS Family Planning Program resulted in closure of more than 53 clinics and the loss of access to preventive care for an estimated 147,000 low-income Texas women.
In response to these drastic cuts, the Texas Women’s Healthcare Coalition was formed, with a mission to restore funding and ensure access to preventive care—including family planning and contraception—for all Texas women. The coalition is comprised of 39 health care, public policy, and faith-based organizations working together on prevention.
Coalition members are passionate about this cause because prevention of unplanned pregnancy means healthier women and babies and reduced tax costs. Nearly half of Texas births result from unplanned pregnancies, with higher risks of low birth weight, prematurity, late prenatal care, poor child health, and abuse or neglect.
Planned pregnancies have a healthier start, with earlier prenatal care, less alcohol and tobacco exposure, more folic acid to prevent birth defects, more breast-feeding, and many positive outcomes for children. The ability to plan pregnancies also allows women and families to achieve their educational goals and improve their financial situation.
With more than 56 percent of Texas births paid for by Medicaid, preventing unplanned pregnancy also reduces tax costs. If they were not reversed, the family planning budget cuts were estimated to cost the state at least $136 million for Medicaid births in three years.
Of course, even with restored funding, there are important concerns. Repairing the women’s health care safety net will take time, and new programs will have administrative challenges. Many experienced family planning providers, like Planned Parenthood clinics, are excluded from funding, which means that other providers will need to be found to absorb the patient volume.
Multiple legislators deserve thanks for their efforts on behalf of women’s health. Rep. Sarah Davis, R-West University Place, led the bipartisan effort for women’s health funding in the House. Her efforts helped to avoid floor battles in the House and made the restoration of lost funds possible. Rep. John Zerwas, R-Simonton, showed outstanding leadership in the appropriations process, as well as during the conference committee. As a physician, his influence on women’s health issues has been critical to the restoration of funding achieved during the legislative session.
Rep. Donna Howard, D-Austin, proposed House Rider 90, which will replace the $32.1 million the state lost in Title X funds this year. It is estimated that this additional funding will provide access to preventive care for an additional 48,000 low-income women across the state.
As chair of the Senate Health and Human Services Article II Workgroup, Sen. Jane Nelson, R-Flower Mound, strongly supported funding for family planning, including contraception. Rep. Jessica Farrar, D-Houston, Rep. Dawnna Dukes, D-Austin, and Sen. Bob Deuell, R-Greenville, also helped support preventive care in the appropriations process.
As chair of the Texas Women’s Healthcare Coalition, I would like to thank TAFP for your extraordinary support of the coalition’s work. As a member of the coalition’s steering committee, the Academy helped to guide our efforts in the Legislature. TAFP CEO Tom Banning was truly a fountain of wisdom throughout the process. TAFP Director of Communications Jonathan Nelson and Communications Specialist Samantha White provided expert help to make our press conferences, press releases, and photographs highly successful.
On behalf of the coalition, thank you!
Members of the Texas Women’s Healthcare Coalition are passionate about this cause because prevention of unplanned pregnancy means healthier women and babies and reduced tax costs. Nearly half of Texas births result from unplanned pregnancies, with higher risks of low birth weight, prematurity, late prenatal care, poor child health, and abuse or neglect.