Cuts to the state’s family planning program have affected the clinic, which also accepts Children’s Health Insurance Program (CHIP), Medicaid, and Medicare patients, she says. The 2011 Texas Legislature drastically reduced funds for family planning services by 66 percent, which caused at least 150,000 low- income women to lose access to preventive care and birth control.
The state budget for family planning services plummeted from $111.5 million for fiscal year 2010–11 to $37.9 million for fis- cal year 2012–13, including federal funds. The family planning program doesn’t provide abortions but gives low-income wom- en and men access to screenings for cancer, sexually transmit- ted diseases, and other diseases and conditions. People’s Community Clinic can no longer offer contracep- tives at a discount, Dr. Neavel says, because the nonprofit lost more than $500,000 in family planning funding. Preventive screenings are no longer free at the clinic either, thanks to the cuts. Patients will have to pay for the services on a sliding scale beginning at $25.
“The annual exam and birth control prescription used to be a covered visit for women at our clinic. Now we have to bill them. At this point, we’re not sure whether we’ve lost patients because of this, but we’re scrambling to fill in the funding gaps so we can continue to provide these services,” said Dr. Neavel. People’s Community Clinic also participates in the Wom-
en’s Health Program (WHP), which provides preventive care, screenings, and birth control (not abortion) annually to more than 110,000 Texas women aged 18 to 44 whom Medicaid would cover if they become pregnant. To participate in the WHP, a woman must be an uninsured U.S. citizen or legal im- migrant. She must have an income at or below 185 percent of the federal poverty level. WHP patients receive one exam each year that covers birth control and screenings for breast cancer, cervical cancer, diabetes, sexually transmitted diseases, and high blood pressure. “I have several patients who are college students and young working women in the WHP. It’s a helpful pro- gram for them and allows them to ac- cess birth control at any pharmacy, not
David Lakey, MD Janet Realini, MD 20 TEXAS MEDICINE July 2012
just the one we have at the clinic,” Dr. Neavel said. She says the clinic will remain in the program even though it’s undergo- ing major changes. The 2011 Texas Legislature excluded affiliates of abortion
providers, including Planned Parenthood, from the WHP. The Centers for Medicare & Medicaid Services (CMS) then said it would cease funding the program because federal law gives women the right to choose from whom they receive health care. The state pledged to take over funding the WHP and developed a transition plan that phases out federal funding by November. Like many physicians, Dr. Neavel fears Texas will witness
increased unplanned pregnancies and preventable diseases as a result of insufficient funding for and reduced access to family planning services.
“This is an especially big concern among teens who have
children already. They need access to birth control so they have an opportunity to finish school and have a shot at a sec- ond chance. We need to invest in prevention to ensure the health and economic future of our state,” she said. Texas Department of State Health Services (DSHS) Com- missioner David Lakey, MD, says the Centers for Disease Con- trol and Prevention recognizes family planning as one of the 10 greatest public health achievements of the 20th century. “Access to disease testing, contraception, cancer screenings,
and education is important and leads to improved health. These services can help identify health problems sooner rath- er than later, reduce unintended pregnancies, and ultimately lower costs,” Dr. Lakey said. The Texas Medical Association House of Delegates demand-
ed that the state restore full funding for the WHP and the fam- ily planning program during its meeting at TexMed 2012 in Dallas in May. (See “Medicine Stands Up for Women’s Health,” page 25.)
TMA supports full and continued funding of family plan-
ning services for uninsured Texas women, including physical examinations; a contraceptive method; and screenings for diabetes, breast and cervical cancer, hypertension, anemia,
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