Texas Governor Greg Abbot has come up with a bad fix for a problem that doesn’t exist. On Monday, state officials announced they would follow the lead of Louisiana and a handful of other states by cutting off reimbursements to Planned Parenthood for services provided to patients with Medicaid. If that happens, the state’s poorest women—specifically, mothers who make less than 19 percent of the federal poverty level—will have fewer options for obtaining contraception, cancer screenings, and tests for sexually transmitted infections.
Texas’ move comes in response to the series of edited undercover videos released in recent months by the Center for Medical Progress, an anti-abortion group that claims Planned Parenthood profits illegally from sales of fetal tissue. In a letter sent to Planned Parenthood’s Texas affiliates, the Health and Human Services Commission cited the videos as evidence of “numerous acts of misconduct,” and accused the organization of fraud. In an announcement of the termination of the Medicaid contract, Abbot said, “The gruesome harvesting of baby body parts by Planned Parenthood will not be allowed in Texas and the barbaric practice must be brought to an end.”
But Planned Parenthood’s clinics in Texas don’t participate in fetal tissue donation. One, in Houston, did partner with the University of Texas for a study on miscarriage, but that was five years ago. As the Houston Chronicle’s editorial board notes, no one has suggested stripping taxpayer funding from the university for being party to “gruesome harvesting.” None of the states or the congressional committees that have initiated investigations in the wake of the videos has uncovered any wrongdoing. Nor does the Medicaid money fund abortions, so Abbot’s claim to be “protecting…the unborn” rings falsely.
If Abbot’s real goal is to deal an existential blow to Planned Parenthood, cutting it off from Medicaid funds probably won’t accomplish that, either. Already the organization doesn’t get much money from Texas ($310,00 in Medicaid reimbursements last year). In 2011, the state locked the organization out of its Medicaid Women’s Health Program, and in June, Abbot approved a provision barring Planned Parenthood from participating in another program that provides breast and cervical cancer screenings to poor women. Planned Parenthood had received about $1.2 million in funding through the latter initiative.
What Texas will accomplish, if it is successful, is to further restrict healthcare options for the poorest women, particularly immigrants and women of color. The state claims that women will be able to find alternate providers, but Texas already has a shortage of physicians who accept Medicaid. Fifty-five percent of Texas women face at least one barrier to obtaining reproductive healthcare, according to a survey released in May by the University of Texas at Austin. Recent history offers little to support the claim that access won’t be affected: Enrollment in the Women’s Health Program dropped by more than 9 percent in the two years after Planned Parenthood was forced out. Providers reported that “they did not know what had happened to their clients, but suspected that they were simply not seeking reproductive health care.”
Planned Parenthood has not said whether it will fight Texas’ decision in court, though it has sued other states that moved to cut off Medicaid reimbursements, including Louisiana, Arkansas, and Alabama. Under Medicaid law, states cannot dictate patients’ choice of qualified provider, so Texas would have to prove that Planned Parenthood is unqualified due to criminal activity or other misconduct. Courts have previously sided with Planned Parenthood over attempts to cut off Medicaid funds in Arizona and Indiana. On Monday, a federal judge ordered Louisiana to continue funding affiliates in the state while the legal battle continues, explaining, “The uncontradicted evidence in the record at this time is that [Planned Parenthood Gulf Coast] does not perform abortions in Louisiana, is not involved in the sale of fetal tissue and none of the conduct in question occurred at the PPGC’s two Louisiana facilities.” A judge in Arkansas has also issued a preliminary injunction requiring the state to continue providing funds.