With the effort to defund Planned Parenthood stalled at the federal level, Texas is spearheading a plan that could “open the floodgates” for states to strip taxpayer dollars from the abortion giant one by one.
Gov. Greg Abbott, a Republican, sent a first-of-its-kind waiver to the Centers for Medicare and Medicaid Services on June 28 asking the agency to approve federal funding for a state-administered family planning program that excludes abortion providers and their affiliates from participation.
If the Trump administration approves the request, Texas Right to Life legislative director John Seago said, it could set off a chain reaction of copycat programs in red states across the nation.
“For the majority of states that want to provide family planning services without sending taxpayer dollars to the abortion industry, that’s a win-win solution,” Mr. Seago said. “Republicans do want a strong network for women’s health services, and the prospect that you can do that while protecting life is something that I think a lot of states would jump on board with.”
CMS will take public comment until Aug. 4 before deciding whether to approve the request.
Texas launched the Women’s Health Program, now called Healthy Texas Women, in 2007 with the goal of reducing Medicaid costs. Initially a joint state-federal venture, the program allocated funds, most of which were federal, to clinics that provide contraception, STI testing, cancer screenings and other health care services to low-income women.
The program nominally banned the participation of clinics that “perform or promote elective abortion” and their affiliates, but the Texas Health and Human Services Commission didn’t try to enforce that prohibition against Planned Parenthood until 2011.
When Texas finally sought to enforce the ban, Planned Parenthood sued, arguing that CMS rules bar the state from excluding clinics just because they perform abortions. In a 2012 ruling, the 5th U.S. Circuit Court of Appeals sided with Texas and upheld the ban.
But when the program came up for renewal, CMS, under the Obama administration, declined to pick it up.
In the ensuing years, Texas continued to fund the Women’s Health Program with state dollars. But now it’s petitioning the Trump administration for federal funding that could amount to $35 million per year.
Kinsey Hasstedt, senior policy manager at the pro-choice Guttmacher Institute, said CMS should reject the waiver.
She said the number of patients seen and contraceptive services performed has gone down since the ban against Planned Parenthood and other abortion providers went into effect.
“The loss of Planned Parenthood, the loss of these types of providers who really focus on reproductive health care and see a high volume of clients every year and do it well, runs absolutely counter to the intent of the program,” Ms. Hasstedt said. “We’ve seen in Texas that it really hurts women’s ability to access publicly funded contraceptive care in that state.”
Mr. Seago said federal funding would only enhance Texas’ ability to provide contraception and other health care services to low-income women.
“It is perplexing that the abortion advocates would be opposed to this waiver, because they are always highlighting the need for more funding of women’s health services,” he said. “It shows that their true purpose is really trying to get taxpayer dollars. They want a piece of the pie, and so they don’t like women’s health programs that don’t include them getting taxpayer funding.”
Mr. Seago said he is “cautiously optimistic” about the waiver’s chances.
It resembles the recent repeal of an Obama-era regulation that prevented states from considering whether a clinic performs abortions when allocating Title X dollars, which are earmarked for family planning services.
Vice President Mike Pence cast the tie-breaking vote to advance the repeal legislation in the Senate in March, and President Trump signed the bill into law in April.
“Signs like that give us confidence that the Trump administration is interested in this type of approach,” Mr. Seago said.
Ms. Hasstedt said the Texas waiver is just the latest in a “sustained and ideologically motivated attack on women’s health and reproductive health.”
“Policymakers opposed to abortion access are trying to find all of these different ways to limit funds going to safety-net providers that offer abortion in addition to other services,” she said. “Coming from a number of state policymakers and now the Trump administration and Congress.”
Conservatives in Congress have promised to redirect Planned Parenthood’s more than $500 million in federal funding to women’s health care clinics that do not perform abortions.
That effort has been sidetracked by debate over the health care bill to repeal and replace Obamacare, of which the measure to defund Planned Parenthood is a part.
With 32 state legislatures, 33 governorships and unified government in 25 states, Republicans may be growing impatient for action on the federal level.
“If Texas’ application is approved,” Ms. Hasstedt said, “it really opens the floodgates for other states to follow suit and has the potential to restrict women’s access to publicly funded family planning services.”