health, they would have faced daunting financial implications. HHSC’s Legislative Appropriations Requests estimate addition- al Medicaid births would cost Texas taxpayers $136 million from 2013 to 2015. Allocating funds to family planning and preventive health care is an investment that will save the state money in the long run, Dr. Lakey says. “We need to make sure we demonstrate that the investment made a difference. We’re building this program to be cost neu- tral through savings in the Medicaid program. If we can dem- onstrate cost savings, we’ll have a platform with bipartisan support that we can strengthen in future sessions,” he said. Dr. Hollier says Dr. Lakey’s vision for expanding the Prima-
ry Health Care Services Program is a good example of increas- ing access to preventive care to help rein in costs. “We need more innovative programs, and we need to en-
courage physicians, Medicaid, and health systems to develop new women’s health initiatives,” she said. The Expanded Primary Health Care Program will serve an estimated 170,000 women aged 18 and older annually. In 2012, the Primary Health Care Services Program served about 46,000 women out of 64,338 clients. Before this legislative session, the program operated on a $12 million annual budget and provided services to patients through 57 contracts with FQHCs, local health departments, hospitals, hospital districts, and nonprofit organizations. Texas residents at or below 150 percent of the federal poverty level (FPL) — a monthly income of $2,943 for a family of four — were eligible for the program. The Expanded Primary Health Care Program is open to residents at or below 200 percent FPL, or a monthly income of $3,925 for a family of four.
Lawmakers to study family planning programs
The Senate Health and Human Services Committee, chaired by Sen. Jane Nelson (R-Flower Mound), will review family planning access and programs before the 2015 legislative session. She said in September the committee is monitoring the implementation of family planning programs supported by the approxi- mately $200 million infusion of new funds. Extending services to women in rural and under-
served areas will be a priority for the committee. “Texas spreads health care resources over a more populated, diverse, and expansive area than any other state, so we must continue to find better ways to deliver services in places that are difficult to reach,” Senator Nelson said. Janet Realini, MD, chair of the Texas Women’s Healthcare Coalition Steering Committee, says the coalition, of which TMA is a member, has requested the study focus on:
• The ability of family planning funding programs to achieve their goals of providing preventive health care to women and save money for the state;
• Ways to better coordinate the various programs to increase the number of women served, ensure an adequate number of providers, and maximize sav- ings to the state;
• The ability of the family planning programs and
agencies to provide statewide access to services across several payer sources;
• How the 2011 cuts to the Department of State Health Services family planning program affect ac- cess to family planning services statewide and the prevalence of unintended pregnancy, number of births, and Medicaid costs to the state; and
• The effect of excluding affiliates of abortion pro- viders from the Texas Women’s Health Program on access to family planning services statewide and on the prevalence of unintended pregnancy, num- ber of births, and Medicaid costs to the state.
Rep. Sarah Davis (R-Houston) says she’ll partici-
pate in the interim study. “I’m hopeful the study will show the family planning
programs are cost-effective and need to be continu- ally funded,” she said. Lisa Hollier, MD, chair of the Texas District of the American Congress of Obstetricians and Gynecolo- gists, says the bipartisan interest in family planning is encouraging. “The interim study provides an opportunity for legislators to learn about the real problems confront- ing women in their districts. I hope the information gathered through the study leads to practical solu- tions, not partisan politics,” she said.
November 2013 TEXAS MEDICINE 25
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