Remove Medicaid birth control barriers
Texas officials are leaving our most economically disadvantaged residents out in the cold in yet another attempt to politicize reproductive health care.
The state’s executive action to exclude Planned Parenthood affiliates from participating in Medicaid took effect Dec. 15, prompting Planned Parenthood to ask for a delay due to the ongoing pandemic. Texas state officials should act with compassion and allow the thousands of Medicaid patients who will be affected to continue getting birth control and essential cancer screenings at Planned Parenthood.
We have seen Texas politicians restrict patients’ access to family planning services at Planned Parenthood before. Recent history shows that women’s health suffers as a result. In 2011, Texas legislators opposed to abortion passed several laws aimed at preventing Planned Parenthood affiliates from receiving public funding for family planning services, even though none of the funding paid for abortion care.
My colleagues and I at the Texas Policy Evaluation Project examined the impact of these changes, and our research found that Planned Parenthood wasn’t the only entity negatively affected by the 2011 legislation. The safety net for reproductive health care was left in tatters as many facilities closed and those that remained open had limited services. Patients who relied on Planned Parenthood for their health care had difficulties finding another provider.
Our studies further showed that there was reduced access to IUDs and implants, the most effective methods that many people want to use, because these were not available from other providers. We also found that some patients relying on injectable contraception were unable to get their next injection
on time and became pregnant.
The recent exclusion of Planned Parenthood from Medicaid will probably have similar effects. This time, it is the lowest income Texans who will be affected. To qualify for Medicaid in the state, a person cannot earn more than the equivalent of 17 percent of the federal poverty level. For a mother of two, this means earning about $300 per month.
These Texans are already struggling. And their circumstances have worsened with unemployment, economic uncertainty, housing and food insecurity, and increased child care demands brought on by the pandemic. A majority of Medicaid enrollees are Latino and Black, groups that have disproportionately borne the greatest effects of COVID-19. Research published earlier this year also reported that more women in the U.S. want to prevent pregnancy because of the pandemic.
Texas policymakers should be diligently working to shore up the reproductive health care safety net rather than creating unnecessary barriers to care and forcing patients to navigate an already fragmented health care system. They should also reconsider the decision to exclude a high-quality provider from providing care when people need it most.
Texas officials tried to justify their efforts to exclude Planned
Parenthood from Medicaid by referring to highly edited videos purporting to show wrongdoing that were later discredited as fraud by a grand jury. They have also repeatedly claimed that Texas Medicaid patients can easily switch providers and receive family planning care elsewhere.
This is not an easy task in Texas. A 2016 survey found that just 30 percent of obstetricians/ gynecologists in the state accepted new Medicaid patients. Texas Policy Evaluation Project research has also reported that many new providers that have been recruited into the family planning network do not provide the same evidence-based care that specialized family planning providers such as Planned Parenthood offer.
Texas officials have an important decision: They can remain the governmental Grinch that strips health care from its most disadvantaged residents in the depths of a pandemic, or they can reverse course and allow low-income Texans to get the reproductive health services they need from the provider of their choice.