How the “Healthy Texas Women” Program Is Failing Women in Texas

Texas has some of the worst health statistics, especially for women. 

According to research compiled by United Health Foundation, Texas ranks 48th in women’s health, 49th in women with dedicated healthcare providers, and 50th in women’s health policies. Approximately 30% of women ages 18-44 lack health insurance, and of the women who have public health insurance, such as Medicaid and Medicare, only 16% of them felt their needs were met. 

Pretty terrible, right? But what does the “Healthy Texas Women” program have to do with this? 

Healthy Texas Women is the Medicaid program offered by the Texas government to individuals with an income of less than $302 per month. The program formed in 2013 after the Texas legislature combined the Texas Women’s Health Program and Expanded Primary Health Care for Women Program to better streamline health care services for more women. This was after the state gutted the Medicaid program in 2011, taking away two-thirds of the state’s family planning budget and terminating state contracts with Planned Parenthood. 

Because the Texas government cut their largest provider of women’s health services (approximately 40% of the women on Medicaid) due to claims that Planned Parenthood affiliates performed abortions, the Obama administration cut federal funding to the state’s Medicaid program. Federal law dictates that women must be able to freely choose their provider, which the Texas government ignored. This decision decimated their source of funding for Medicaid, cutting their budget in half. Texas would have to find ways to serve more of their low income women with a lot less money — hence the conception of Healthy Texas Women.

But … the number of women served by the Healthy Texas Women program actually decreased, continuing the decline in clients that began after 2011. From 2011 to 2016, enrollees decreased by 24% and the number of health care services accessed fell by 39%. In 2018, only 70% of women in the program used the healthcare services offered, and most of the providers under the program have not actually served any of the clients. In fact, the Texas Health and Human Services Commission billed only 10% of the program’s providers. 

Unintended pregnancies seemed to increase under this program, directly contradicting one of its main goals. Under the Healthy Texas Women program, there was a 35% decrease in the women getting IUDs and other long-acting contraceptives, which is cited as one of the most effective types of birth control. Injectable contraceptive admission decreased by 31% and Medicaid-paid births rose by 27%. 

A coincidence? I think not. 

But instead of advocating for reform to the program, the Trump administration has decided to reward Texas’s anti-choice rhetoric, pledging to reinstate federal funding to Texas’s Medicaid program. With an addition of $69 million from the federal government, the Healthy Texas Women program will reallocate the state budget, but will not change the amount of money set aside for the program. Texas is also one of the 14 states that did not expand Medicaid under the Affordable Care Act, denying coverage to millions of women within its borders. 

With 3 in 10 women in Texas classified as low-income and 1 in 5 uninsured, it is incredibly dangerous that the Healthy Texas Women program is being rewarded for its incompetence. Many worry that the re-instated funding for Texas will be used as an example for other states in their quest to restrict accessibility to family planning and reproductive care by low income individuals. 

Ideology has no place in healthcare. The Health Texas Women program needs to be reformed to better serve its constituents. Expanding Medicaid and renewing contracts with Planned Parenthood affiliates would be a start, but much more needs to be done. Texas women deserve better. 

 

Featured Image: Harriet Lee-Merrion, The New York Times