A new report shows that Texans in the Rio Grande Valley are now unable to access the affordable reproductive health care that was available to them just a few years ago, before conservative state legislators drastically cut family planning funds, causing more than a quarter of the area’s family planning clinics to shutter.
A joint effort between the National Latina Institute for Reproductive Health (NLIRH) and the Center for Reproductive Rights (CRR), the Nuestro Texas report is the result of interviews with nearly 200 self-identified Latinas in the Rio Grande Valley, the four-county area at the southernmost tip of the state.
“The state has violated these women’s human rights, including their rights to life and health,” said CRR Vice President for Programs Luisa Cabal on Tuesday, at a panel highlighting some of the report’s findings at the state capitol in Austin.
Nine of 32 family planning clinics in the Rio Grande Valley have closed over the last two years, leaving some of the poorest Texans without the affordable, and sometimes even no-cost, contraceptives and cancer screenings that were available through state family planning funds.
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The Valley, home to 1.3 million people, is one of the poorest areas in the United States, with a third of its residents living in poverty. According to the Nuestro Texas report, Hidalgo County, one of the four counties in the Valley’s geographical designation, has “the highest rate of uninsured people among urban counties in the entire nation.” This in a state that already boasts the highest uninsured rate in the nation.
CRR and NLIRH representatives joined legislative staff and Valley activists at the capitol for Tuesday’s panel to discuss the report, which Cabal said “puts a face to reckless political indifference.”
The report features first-person stories from Valley residents, many of whom live in colonias, neighborhoods that often lack access to basic infrastructure like water, electricity, and sewage. The Nuestro Texas report features interviews with Valley Texans affected by family planning cuts—Texans who are now facing unplanned pregnancies and undiagnosed or untreated cancers.
Researchers found four major barriers to reproductive health-care access: lack of accessible clinics, cost, transportation, and immigration status. Latinas that researchers spoke to reported seeing border patrol and immigration agents outside reproductive health clinics.
Combinations of some or all of these barriers affect the 188 Latinas interviewed. Among them is Ida, from Donna, Texas, who has been treated for cervical cysts in the past, but who now cannot get the biannual Pap tests her doctors recommend. From the report:
“It’s $60 for a checkup. I thought, either I pay $60 or I buy food for my children. … Sometimes I don’t have money for milk, food, other things … Either I pay the rent and give my children a place to live, or I have a mammogram, a Pap test, or contraceptives. It’s one or the other, but not both.”
While the state did restore some of the funds that legislators cut from family planning allocations in 2011, the restored monies are being predominantly directed to primary care clinics and physicians, many of which lack the specialty care experience that made Planned Parenthood and other dedicated family planning clinics both cost-effective and able to see high volumes of clients.
According to the Texas Policy Evaluation Project at the University of Texas, the state was already only addressing about a fifth of the need for affordable reproductive health care in the state with the money it allocated before the 2011 cuts. Now, under the partially restored funding structure, Nuestro Texas has found that “women may not be able to receive the same quality of family planning goods and services through primary care providers.” Indeed, in 2012, Texas’ Department of State Health Services spent $37 more per client to see half the number of people it saw the year before before the legislature’s family planning funding cuts.
That leaves more of the Texans who are most in need—such as Daniela, who lives in a colonia near Harlingen—with no transportation and no way to access clinics and resources that were present just two years ago. She finally made it to a clinic for a mammogram in January of this year after waiting six months for an appointment, but the clinic staff told her there they “no longer had the equipment” to do the exam. She told researchers:
“Time is going by and what if I have something? And by the time I get checked they’re going to tell me, ‘You know what, you have cancer and this and that.’ I don’t even think about it. I try to live with it.”
According to the report, the cost of a month’s supply of contraception and fees for annual exams have increased “by three to four times since 2010,” and so even when appointments at the clinics that are still open are available, they may be financially inaccessible. Esmerelda, from Mission, told researchers:
“When they took the funding for contraceptives away and I couldn’t get them [for free] anymore…. [It costs] $50 a month, but I can barely make ends meet. That’s when I got pregnant.”
The report emphasizes the deliberate nature of the funding cuts, championed by right-wing legislators, including Gov. Rick Perry, who have hopes of defunding and even altogether eliminating Planned Parenthood’s provision of reproductive health services in the state, because Texas considers Planned Parenthood an abortion “affiliate.” Instead of addressing the extant and growing need for reproductive health care in the state, Nuestro Texas researchers write, lawmakers chose to make the problem worse:
Yet, rather than allocating a greater share of reproductive health resources to underserved areas like colonias, or addressing the structural barriers such as poverty and transportation that prevent women from accessing timely and appropriate care, Texas has implemented reproductive health policies that will further undermine access to care and exacerbate health disparities.
At Tuesday’s panel, reproductive rights activist Lucy Felix said, through an interpreter, that even though her fellow Valley Latinas are facing “huge risks” and “incredible barriers,” they will “continue to raise their voices.”
“These women are fearlessly organizing for change,” said Felix, “and we are are achieving it.”