Delivering The Bad News To Texas Women: Your Trusted Provider Can’t See You Anymore

When clients come to the Downtown Planned Parenthood Clinic in Austin, Texas, they're coming to get what they've always gotten: contraception, cancer screenings and STI tests. But what they're getting, if they're on the newly defunded Medicaid Women's Health Program, is bad news: Planned Parenthood can't see them any more.

Rally in Austin, outside the Texas Dept. of Health. [img src]

When clients come to the Downtown Planned Parenthood Clinic in Austin, Texas to see clinical nurse Suzy Campbell, they’re coming to get what they’ve always gotten from the east side clinic that’s been serving the community for nearly forty years: contraception, cancer screenings and STI tests. But what they’re getting, if they’re on the newly de-funded Medicaid Women’s Health Program, is bad news: Planned Parenthood can’t see them any more.

Not because Planned Parenthood doesn’t want to provide the same care they’ve always given to low-income women in Austin, but because this spring, Texas state officials and lawmakers decided they’d rather de-fund one of the state’s most cost effective programs than allow Planned Parenthood to participate.

“We’re having to be the bearer of bad news,” Campbell told Rewire this week, in a few quiet moments between seeing her patients at the clinic. Ostensibly the Texas Health and Human Services commission should be letting women on the WHP who are Planned Parenthood clients–about half of the 130,000 women in the program–know that they can no longer go to the health providers they’ve trusted for years. But so far, women have been getting that news from Planned Parenthood itself, which has been announcing its own demise, patient by patient.

“Patients are left in the dark,” said Campbell. The state’s HHS department has taken over the federal program that, until last month, was 90 percent funded by the federal government. Now, the state says it will fund the $40 million program on its own–and find non-Planned Parenthood providers to pick up the slack across the state. That means notifying WHP clients about the change, usually by mail to safe addresses they’ve provided to Medicaid.

By the end of May, when the program will officially end in Texas, tens of thousands of women will have to find new places to get their reproductive health care. For most, it’s not  something they can wait months on waiting lists to get from new doctors. Emily Howell, for example, got her last Depo-Provera shot in March at Austin’s downtown Planned Parenthood clinic. She found out during that appointment that she’d have to find a new provider when she happened to come into the clinic for her regular shot.

“I didn’t know about it until I went to my appointment,” said Howell, a full-time student and environmental activist. Sure, she says, she knew there’s “always the whole politics and conflict,” but never expected to be told, as she checked in, that this would be her last visit. She was shocked: “This is how I find out?”

Howell hasn’t heard a word from HHS, which told Rewire they’ll be sending out letters to the safe addresses provided to them from WHP clients, and also providing a call-in number where women can get more information. But letting 130,000 women know that their health care may be in jeopardy takes time… time women who need reproductive care might not have.

“I received my last Depo shot from them literally a week before the program ended,” explains Howell. She needs to switch to a new form of contraception because of the length of time she’s been taking Depo, and now doesn’t know who she can talk to about her alternatives.

“I’m not sure what I’m going to switch to,” she said, “and unfortunately Planned Parenthood is the best place and has the best people to talk to about that kind of stuff.”

In Texas, the WHP meant one less thing for low-income women to worry about: they knew where they could get timely, regular reproductive health care when they needed it. Now they’re left wondering if they can enroll in different government programs for aid, or see a new doctor in time to get prescription refills and screenings. Women with high-risk HPV, for example, may need pap smears every few months–putting their health care on hold mean be the difference between catching abnormal cells in their earliest, treatable stages or having to go through a much scarier, more complicated ordeal if precancerous cells advance.

For now, Howell has been able to enroll in her county’s Medical Assistance Program, a benefit only a few Texas women get.  Travis County, where Austin is located, happens to have funds available for low-income women. But she’ll have to go to a community clinic that doesn’t specialize in women’s health, and she’s already waited weeks for an appointment. And because Howell is approved for MAP for just six months, the future of her reproductive health care is still uncertain. 

Sarah Wheat, interim CEO of Planned Parenthood in Austin, says she doesn’t buy what the state is selling when it says existing providers can address the needs of the tens of thousands of women Planned Parenthood currently sees on the WHP.

“Everything the state is saying is absolute politics,” she told Rewire. For her, the most “heartbreaking” part of the situation is how it punishes people trying to do the right thing–trying to get reproductive health care so they can plan and care for their families.

“You’re doing what we as a country want you to do, which is take care of yourself and your family.”