Texas Medicaid patients are suffering the consequences of a dangerous political game. Here’s what happened.
During statewide power outages from a recent massive winter storm — and, ya know, the ongoing COVID-19 pandemic, Texas Gov. Greg Abbott acted to exclude Planned Parenthood from Medicaid. What’s more, he only gave patients 30 days to find another place to go for sexual and reproductive health care. Planned Parenthood fought for patients to have six months to find another provider, but Abbott wouldn’t budge.
That meant some of the most vulnerable communities just faced three life-threatening issues at the same time: deadly power outages that created a reproductive health crisis, COVID-19, and a sudden lack of access to lifesaving health care at Planned Parenthood health centers.
But the Biden administration was clear: No state can “defund” Planned Parenthood or any other qualified Medicaid provider. Under federal Medicaid law, patients have the freedom to choose where they go for their health care.
“[President Biden] reissued guidance specifying that states cannot refuse Medicaid funding for Planned Parenthood and other providers. HHS… stated they are committed to protecting and strengthening the Medicaid program as is the President consistent with the Executive Order we released."
— White House Press Secretary Jen Psaki (Feb. 4, 2021)
Unfortunately, just a few weeks later, Gov. Abbott ignored the White House’s warning. On March 10, 2021, Gov. Abbott got the go-ahead from a state court to carry out his years-long mission: blocking patients with low incomes from getting treated by the providers they know and trust at Planned Parenthood.
Gov. Abbott’s direct defiance of the White House might score him a few political points in the short term, but his reckless actions could jeopardize federal funding for the Medicaid program in Texas — which provides affordable health care to more than 4 million people in the state every year.
The People Who Use Medicaid at Planned Parenthood
Gov. Abbott’s political games severely limit Medicaid patients’ options on where to get their next round of birth control, be tested for STIs, get screened for cancer, or receive other preventive care that they usually access at Planned Parenthood health centers. Many Medicaid patients are essential workers, people of color, and single parents.
Texas already had a severe health care provider shortage before the COVID-19 pandemic, after years of relentless attacks on health care access by Gov. Abbott and his political allies.
Even the limited number of providers who serve people with Medicaid health insurance aren’t always taking new patients. For some people, Planned Parenthood was the only place where they could get same-day appointments. So, Texans with low incomes have few places to turn for the type of preventive sexual and reproductive health care that Planned Parenthood provides.
Planned Parenthood patients also know and trust Planned Parenthood. Gov. Abbott is taking away Texans’ right to choose which provider is best for them, forcing people who only feel comfortable getting sexual and reproductive health care at Planned Parenthood to find a different provider anyway — and find it fast.
History of Texas “Defund” Attacks
Gov. Abbott’s attack on patients insured through the Medicaid program is part of the state’s lengthy, calculated history of relentlessly attacking Planned Parenthood patients and health centers.
Texas made massive funding cuts to the state’s family planning program and started a tiered-funding scheme that essentially blocked providers like Planned Parenthood from the small amount of funding that remained.
As a result of the budget and funding changes, Texas’ family planning program served 54% fewer patients.
Texas tried to exclude Planned Parenthood from the state’s federally funded, Medicaid-based family planning expansion program — but the Obama administration refused to approve this exclusion.
Texas replaced that program with a family planning program funded only by the state. In doing so, Texas opted out of millions of dollars in federal funding, which would have gone toward health care for Texans with low incomes.
Within two years, nearly 30,000 fewer family planning program patients received birth control, cancer screenings, STI tests, and other preventive sexual and reproductive health care.
82 family planning and sexual and reproductive health centers (one out of four) closed or eliminated family planning services across Texas. One-third of those were Planned Parenthood health centers.
Texas officials physically raided Planned Parenthood health centers.
Texas officials announced they would terminate Planned Parenthood’s Medicaid contracts and block all Medicaid patients (not just those in the family planning expansion program) from receiving care at Planned Parenthood health centers. A federal court later blocked that termination.
Gov. Abbott passed a budget that banned Planned Parenthood from the state's Breast and Cervical Cancer (BCC) Services program, which provides vital cancer screenings to low-income and uninsured women.
- After Donald Trump became president, Texas sought new federal funding for its failing family planning program.
- That program had barred patients in the program from accessing preventive care at Planned Parenthood and other health centers that provide abortion since 2013.
Instead of ensuring patients could access qualified, affordable sexual and reproductive health care at Planned Parenthood, Gov. Abbott funded fake clinics designed to shame people out of choosing abortion.
Those crisis pregnancy centers were caught mismanaging taxpayer money.
The Trump administration upended longstanding federal law and greenlit Texas’ request to again receive federal Medicaid funding for its failing family planning program (which had been state funded after the Obama administration denied a similar request in 2012).
Gov. Greg Abbott exploited COVID-19 to block access to time-sensitive, essential abortion services, forcing some patients to travel hundreds of miles to neighboring states during the pandemic to get the care they needed — if they could get care at all.
The termination of Planned Parenthood’s Medicaid contracts in Texas became effective March 10, 2021, after a 2020 federal appeals court overturned the previous order — jeopardizing health care access for thousands of people.
Bottom Line: Everyone Deserves Access to High-Quality, Affordable Sexual and Reproductive Health Care
As in all “defunding” attacks, Planned Parenthood’s priority is ensuring patients with low incomes are treated just the same as patients on private insurance plans. They shouldn’t have fewer choices — no matter where they live.