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Texas Low-Income Women: Canaries in the Coal Mine?

Texas cuts to family planning aid have been the “most radical” of any state – and may be a harbinger of things to come nationally  © Corbis.  All Rights Reserved.
Texas cuts to family planning aid have been the “most radical” of any state – and may be a harbinger of things to come nationally © Corbis. All Rights Reserved.
October 2, 2012

MCALLEN, Texas - Texas has cut funding to family-planning services more deeply than any other state, according to a new study. The three-year study by the University of Texas' Population Research Center is published in the New England Journal of Medicine.

More than 60 clinics have closed so far, while others have reduced hours, increased fees and restricted services. The effect on low-income women has already been dramatic, and with the state's Women's Health Program on the brink of losing all federal aid, further cuts are on the way.

Patricio Gonzales is CEO for Planned Parenthood of Hidalgo and Starr Counties, in the impoverished Rio Grande Valley, where four of his eight clinics had to shut down last year. He says more than 15,000 area women now have nowhere to go for their health-care services.

"These services are life-saving, for cancer screenings, for birth control, for physical exams, because no other provider can pick up these women. And if these women don't have access to this program, well, they're going to go without."

Legislators in 2011 slashed family planning aid by two-thirds, or $73 million. Then, they ignored federal Medicaid rules by excluding certain clinics, such as Planned Parenthood's, from the Women's Health Program, causing the feds to cut off more than $30 million a year in subsidies. The state is fighting that move in court.

Family planning has become a political lightning rod nationally, and presidential candidate Mitt Romney has said he wants to eliminate Title X, the program that has ensured preventive-health and contraceptive services since 1970. Gonzalez says politicians should take a close look at Texas, where he thinks low-income women have become the nation's "canaries in the coal mine."

"This is just a sample of what will happen if politics continue to threaten Title X in other states. We have closed clinics, we have laid off staff. We have dismantled the safety net that we created so many years ago."

State officials say they're busy enlisting comprehensive health-care providers to take up the slack, but Gonzales doubts that the women who are losing their clinic-based care will be able to get into, or afford, the alternatives.

Gonzales thinks politics, not budgets, are mainly responsible for the cuts. Lawmakers argue they're making sure public money doesn't pay for abortions, something that Title X already prohibits. He says spending on preventive services saves money by reducing emergency-room care and unintended pregnancies.

"For every one dollar invested in family planning you save four dollars. It's a great investment for our taxpayers and our community."

On average, Planned Parenthood clinics get about two-thirds of their income from donations and fees paid by the clients they serve; the rest comes from public aid. That's why more clinics are shutting down in poor areas where clients can't afford fees.

Gonzales says at least two of his remaining Valley clinics will have to shut down if Texas loses its federal Women's Health Program aid, as scheduled, on November 1.

See the NEJM study at

Peter Malof, Public News Service - TX