The United States is one of the few “developed” countries that denies its citizens access to affordable healthcare and has failed to provide much needed medical services during a worsening pandemic. Millions have lost their employer health insurance with the pandemic’s accompanying waves of job losses and lack of individual economic protections granted by Congress. With the highest uninsured rate in the nation and a higher unemployment rate than the national average, Texas fares worse than most states, particularly their recently unemployed low income workers who lack basic income and health care access.
With all of this ongoing chaos, the Texas government still managed to continue its tradition of repressing access to reproductive care. In May of this year, the Health and Human Services Commission (HHSC) tried to cut $133 million in funding including $3.8 million from women’s health programs, citing budget restraints due to Covid-19. While state administrators suggested siphoning funds from programs that provided important preventative services (i.e. contraception, screenings, and assistance in enrollment into safety net programs), they left the funding for Texas’ anti-choice Alternatives to Abortion (A2A) program untouched. While outrage from reproductive health advocates and constituents pressured administrators to reverse their budget proposals, the prevailing A2A program serves as a reminder that the fight for accessible reproductive health care in Texas is far from over.
Created in 2006, the A2A program funnels some state funding into maternity homes and adoption centers, but directs most of its money to crisis pregnancy centers (CPCs). An apt name — CPCs do target pregnant people in crisis, but only to dissuade people from having abortions. CPCs direct most of their funding to counseling rather than their other stated services such as maternity clothing, diapers, and childbirth classes. Instead of objectively showing their patients their available options, counseling largely consists of staff members pushing a Christian anti-choice rhetoric through medical lies and victim blaming. CPCs also don’t have medical supplies or personnel; while many lure in unsuspecting pregnant clients with free ultrasounds, the ones provided by CPCs don’t meet the mandated ultrasound required the day before an abortion procedure.
If advocates and legislators alike know the A2A program lacks credibility, couldn’t they force the program to provide accurate reproductive healthcare services and education? Sadly, the answer is no. The state government provides very little oversight for the A2A program, requiring its contractors to only submit the number of clients they serve and anecdotal “success” stories. Little evaluative information is given regarding measures of benefits, services, and cost-effectiveness, which is usually mandatory for other state health programs.
Despite controversies surrounding the A2A program, the state legislature continues to increase its funding every session. Beginning with a budget of $5 million in 2006, the A2A program has received approximately $170 million in total through 2021. State legislators have redirected funds from important safety net programs like Temporary Assistance for Needy Families (TANF) and vital state entities like the Texas Commission for Environmental Quality (TCEQ) to these anti-choice centers. As A2A funding increases rapidly each biennium, attacks on preventative care and reproductive health care continue at a similar rate. Since the state government slashed their family planning funding to one-third of its original size in 2011 and cut Planned Parenthood from the Medicaid program, about 80 clinics have shut down or stopped providing family planning services, leaving over 50,000 people without any source of preventative healthcare.
Texas also leads the nation in “abortion deserts.” As of 2018, only 21 clinics provided abortions compared to the 170 active CPCs scattered throughout Texas. With the highest uninsured rate for women of child bearing age in the US and abysmally high rates of maternal mortality and morbidity, Texas’s continued support for nonmedical, ideologically-driven clinics is dangerous, particularly for the most vulnerable.
People with uteruses have never had full bodily autonomy, especially people of color. The Texas government and medical system serve as a historical testament to that through their continual failure to care for millions across the state. So what can Texas do to provide its citizens with proper preventative and reproductive healthcare? Much of the state’s healthcare environment depends on upcoming Supreme Court hearings, where the dissolution of the Affordable Care Act is on the table. With hearings regarding Medicaid payments to abortion providers and the potential reversal of Roe v. Wade, access to reproductive care also hangs in a limbo. In the upcoming 87th session, the least that the Texas legislature can do is stop funneling state tax dollars into the already bloated, dangerous A2A program and stop diverting funds from important safety net programs like TANF. Anti-choice religious ideology does not belong in state government and most importantly, in reproductive healthcare settings. Preventative and reproductive healthcare should be a guarantee for every individual, regardless of their anatomy, race, or income status.
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