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NEWSillo tkJumping the Sharkon Women’s HealthFor the sake of anti-abortion politics, the governorand the Legislature are putting women in dangerBy Jordan SmithIn mid-December, before a friendly crowdat the Source for Women, a Houston antiabortion“pregnancy resource” center, Gov.Rick Perry announced his women’s healthpriorities for the 83rd legislative session:Increase regulation on abortion facilities anddoctors, and outlaw all abortion after 20weeks gestation, the point at which, Perrysaid, “a baby can feel the pain of being killed.We have an obligation to end that type ofcruelty,” he proclaimed to vigorous applause.“We cannot, and we will not, idly stand bywhile the unborn are being put through theagony of having their lives ended.”Whether a fetus can in fact “feel pain”that early in a pregnancy is unclear; a 2005review of available research, published inthe Journal of the American Medical Association, found that while a fetus may exhibitbase reflexes by 20 weeks, it isn’t until thethird trimester that the nervous system issufficiently developed to actually registerpain. In any case, the incidence of abortionafter 20 weeks of gestation is exceedingly20 T H E A U S T I N C H R O N I C L E JANUARY 18, 2013 a u s t i n c h r o n i c l e . c o mrare: Of the 77,592 abortions performed inTexas in 2010 (the most recent year withcomplete statistics), just 420 proceduresoccurred after 20 weeks – and many if notmost of those procedures were the result ofserious medical complications.Last week, in his opening day address tothe Lege, Perry reiterated his claim, andmay designate passage of a “fetal pain bill”as a legislative emergency item – moreurgent than public education, water planning,or addressing the $4.5 billion Medicaidshortfall. In 2011, Perry designated an ultrasound-before-abortionbill an emergencyitem, touching off a protracted legislativebattle. The law eventually passed, requiringwomen seeking an abortion to first undergoan invasive, narrated ultrasound procedure.As of press time, Perry spokeswomanLucy Nashed said there were as yet noannouncements to be made on potentialemergency items. Sarah Wheat, vice presidentfor community affairs for PlannedParenthood of Greater Texas, said Perryj a s o n s t o u tIn court, the state has arguedthat furthering a “pro-life”message is as importantas actual health care.might well wait until later this month, whenthe annual Texas Rally for Life convergeson the Capitol. At that rally, Perry oftendelivers his most pointed attacks on reproductiverights. “It will be interesting to see,”said Wheat, “if he designates somethingthat is clearly not a public health emergencyas a public health priority.”The Real CrisesFor when it comes to women’s health,state lawmakers have very real, serious, andbroadly significant matters to address. Mostobviously, the family planning and basicreproductive health services budget meantto serve low-income, uninsured Texaswomen was all but destroyed in 2011. As aconsequence, dozens of veteran family planningproviders closed, and more than 100,000women lost access to basic health care.The dismantling of the traditional familyplanning program also had a ripple effecton the vibrancy of the Women’s Health Program,which until Jan. 1 was a Medicaidwaiverprogram designed to amplify thestate’s ability to serve low-income womenin need of reproductive health services. TheWHP was created in 2005 to take advantageof a 90% federal funding match in order toreduce the number of unplanned pregnanciesin the state paid for by Medicaid –roughly 56% of Texas births are paid for bytaxpayers (more than 220,000 in 2010) – byextending government-paid family planningservices to women who wouldn’t beeligible for Medicaid unless pregnant. Theprogram has by all accounts been a greatsuccess, but during the legislative interim,state officials instituted new rules for providers– rules written expressly to excludePlanned Parenthood, the state’s largest providerof WHP services, from participation inthe program, because some Texas lawmakersconsider the nearly century-old nonprofitnothing more than an abortion “promoter”and provider. Neither the fact thatpregnant women are ineligible for the WHP,nor that none of the PP clinics involved in itactually provide abortion services, has dissuadedTexas officials.That rule change – which is contrary tofederal law – resulted in the feds pulling allfederal funding for the WHP. Meanwhile,more than 40,000 additional women will nolonger be eligible for state health servicesunless they leave Planned Parenthood andchoose a state-approved provider. The newrules have also kept the state involved inlitigation for more than a year, defendingits right to choose the health care providersfor low-income women. In court, thestate has argued that furthering a “prolife”message is as important as actualhealth care and preventing unwanted pregnancies– and that the involvement of PPdilutes that message.In that political context, women’s healthadvocates aren’t optimistic about the newLegislature. Will lawmakers comprehendhow recent policies have led to the destructionof the health care safety net, or willthey continue to push a social agendawrapped in regulations and budget cuts,despite its disastrous effects on the state’smost vulnerable women and families? “It isirrefutable, the public health damage thathas been done,” says Wheat. “Texas is onsuch a misguided path when it comes towomen’s health right now. We are on trackto be one of these states where people justroll their eyes because what we’re doingmakes no sense.”Collateral DamageThe pressure on women’s health careproviders across the state had been buildingover the years, but the 2011 sessionwas the most brutal in recent memory.The dismantling of the women’s healthcare network proceeded on two distinctbut related tracks – drastically reducingthe state’s budget for traditional familyplanning programs, and then rewritingrules for the WHP. The efforts shared thecommon political goal of defundingPlanned Parenthood.By the Numbers*: Texas Women’s Health Care• Texas women in need of family planning services (est.): 1.5 million• State family planning funding, 2009-2011: $100 million• State family planning funding, 2011-2013: $38 million• Annual clients served by family planning, prior to funding cuts (avg.): 244,000• Number of Texas family planning clients served, 2011: 203,000• Number of Texas family planning clients served, 2012: 75,160• Number of family planning clients losing service, 2011 to 2012: 128,000• Number of clients losing service, WHP and family planning (combined est.): >167,000• Number of Planned Parenthood clinics closed by funding cuts: 13• Total number of clinics closed by funding cuts: 60• Women’s Health Program clients served by Planned Parenthood, 2012: >40,000• Women’s Health Program clients served by Planned Parenthood, 2013: 0• Number of Texas births funded by Medicaid, 2010: >220,000• Percentage of Texas births paid for by Medicaid: 56%• Est. additional Medicaid births due to no access to birth control, 2013: 23,000* chart numbers rounded