REPORT OF COMMITTEE ON MATERNAL AND PERINATAL HEALTH
CM-MPH Report 4-A-06
Subject: State Funding for Family Planning and Preventive Health Services for Women
Presented by: Janet Realini, MD, MPH, Chair
Referred to: Reference Committee on Public Health
For years, publicly-funded family planning clinics across Texas have offered uninsured women needed preventive care: physical examinations; a contraceptive method; and screenings for diabetes, breast and cervical cancer, hypertension, anemia, and other infections and diseases. The Texas Family Planning Program, which is funded through federal grants, typically has served about 400,000 women each year, leaving about 1.5 million other women still in need of subsidized services.
However, for the 2005-07 biennium, the Texas Legislature has shifted funds away from the state's long-time family planning contractors and agencies, damaging their finances and displacing thousands of women from their family planning provider.
The Deuell Rider to the 2005-07 appropriations bill diverted $20 million from established family planning clinics to Federally Qualified Health Centers (FQHCs); the Williams Rider shifted another $5 million away from medical care to programs "for women seeking alternatives to abortion focused on pregnancy support services that promote childbirth" (i.e., crisis pregnancy centers).
The result is that 38,000 low-income women will be displaced as a consequence of the shift of funding to FQHCs, and according to the Texas Department of State Health Services, nearly 17,000 women may lose access to reproductive health care as a result of the Williams set-aside. Many experienced family planning clinics are cutting staff and hours, or closing clinic sites. Unfortunately, FQHCs, which offer primary care to poor neighborhoods, are not available in all counties and neighborhoods that need them. Crisis pregnancy centers do not offer medical care at all.
The Committee on Maternal and Perinatal Health is concerned that low-income women will not have access to preventive care, and will experience more unplanned pregnancies and abortions. In addition, the health of women who are displaced from preventive care will be at risk from cancers, infections, hypertension, diabetes, and depression that will not be detected or addressed.
Recommendation : That the Texas Medical Association support full funding of family planning services for uninsured women in Texas, including physical examinations; a contraceptive method; and screenings for diabetes, breast and cervical cancer, hypertension, anemia, and other infections and diseases, and that TMA (1) oppose redirection of family planning funds to nonmedical services for pregnant women, and (2) request that the Texas Department of State Health Services track how the shift of federal funds from family planning clinics to Federal Qualified Health Centers and alternatives-to-abortion programs affects (a) the use of preventive services, (b) the rate of births to low-income women, and (c) the rate of abortions among low-income women.
TMA House of Delegates: TexMed 2006