Some of the most vulnerable people in Texas could be facing a health care crisis if a new rule proposed by the Trump administration goes into effect.
Rolled out in full late Tuesday, the proposed change to the Department of Health and Human Services Title X family planning program would ban any entity receiving cash from the program from providing, supporting or even referring patients to abortion services, largely reinstating the so-called domestic "gag rule" on abortion providers implemented by the Reagan administration in 1984.
According to numbers published by the U.S. Census Bureau in September, Texas has the highest rate of uninsured residents in the country, at about 16.6 percent, or almost double the national rate of 8.8 percent. One of the easiest routes to reproductive health care for women in that 16.6 percent is visiting one of the clinics in the state that participates in the federal program. Now that safety net is under threat.
"[The rule change] is a deal-breaker," says Sarah Wheat, chief external affairs officer for Planned Parenthood of Greater Texas. "Health care providers are not going to be willing to compromise their ability to talk to their patients and share all the accurate and honest resources that they have. It's clearly intended to drive providers like Planned Parenthood out of the program."
For Texas Planned Parenthood clinics, federal funding is especially vital, thanks to the restrictions the state has placed on funding for the last seven years. In 2011, the Legislature drastically cut Texas' state budget for family planning services in an effort to defund Planned Parenthood. In the years that followed, more than 80 family planning clinics, about 1 in 4 statewide, closed, according the research from The Washington Post .
"These federal funds provide basic health care that is so needed, especially in Texas," Wheat says. "The patients that we serve with these funds are uninsured, low-income Texans who are seeking an HIV test, a cervical cancer screening or treatment for an STD. ... In Texas, those resources are limited. For uninsured, low-income women, this is often their primary source of health care."
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None of the Planned Parenthood clinics in Texas that receive Title X funding, including clinics in Cedar Hill and North Dallas, provide abortion services, but their funding would still be imperiled because doctors at the clinics are not going to stop referring patients seeking abortions to appropriate facilities, Wheat says.
"It would be problematic for our medical professionals who are in those health centers. They wouldn't be legally allowed to tell a woman verbally what all of her options are," Wheat says. "This would completely undermine what has been a lifeline for uninsured and lower-income women."
For now, Wheat says, Planned Parenthood Greater Texas is focused on making sure that the Department of Health and Human Services and state lawmakers hear plenty from the state during the comment period for the rule, which ends two months from Tuesday.
"At this point, we want to make sure Texans really know what's at risk, and then we're going to be helping them lift up their voices and make sure our elected officials know this is not on track with what Texans want or need," she says.