Q. What is the Women’s Health Program?
A. The Women’s Health Program (WHP) is a Medicaid program that provides checkups and birth control, but not abortion, to low-income, uninsured women who would receive Medicaid if they were pregnant. This limited-benefit program is available to women ages 18 to 44 who are U.S. citizens or legal immigrants and whose income is at or below 185 percent of the federal poverty level (under $27,213 for a family of two).
A result of bipartisan legislation, WHP is a pilot program that began in 2007 and has served more than 235,000 women. The Texas Health and Human Services Commission calculates that by helping women avoid unplanned pregnancies, the program has saved the state more than $37.6 million in its first two years of operation.
Q. What services does WHP cover?
A. WHP covers preventive care and contraception, including a yearly examination with screening for breast and cervical cancer, diabetes, high blood pressure, high cholesterol, tuberculosis, and sexually transmitted diseases. WHP also covers education and counseling about family planning, including natural family planning and abstinence. WHP does not cover abortion or emergency contraception (the “morning after pill”).
Q. Does WHP save money?
A. Yes. Preventive services through WHP cost much less than pregnancy-related services. The Texas Health and Human Services Commission calculates that WHP saved Texas more than $37.6 million in its first two years of operation. For every $1 in general revenue (GR) that Texas spends on WHP, our state saves more than $10 in GR.
Q. How does WHP achieve savings?
A. WHP reduces Medicaid costs by helping participating women plan when or if they want to become pregnant. Women are provided birth control and education about how to use it effectively. By helping enrolled women control their own fertility, Texas Medicaid pays for fewer births and the associated health care costs for newborns.
WHP helps enrolled women better space their pregnancies, which leads to healthier mothers and babies. Studies show that when pregnancies are 18 months or less apart, known as “short interval” births, babies are more likely to be born prematurely or with low birth weight. Babies born too soon or too small are more likely to suffer from serious health problems, which contribute to higher utilization of health care services, including neonatal intensive care services at birth.
Q. How much does WHP cost?
A. On average, WHP costs $241 per woman, of which Texas’ portion is $24. The federal government pays 90 percent of WHP patient-care costs. By contrast, for each pregnancy, delivery, and subsequent first-year infant health care costs, Medicaid spends more than $16,000, of which Texas pays $6,621.
Q. Does providing contraception really prevent that many pregnancies?
A. Yes. A wealth of evidence demonstrates that contraceptive use dramatically reduces unplanned pregnancy. Although no method of contraception is perfect, access to contraceptive services helps women avoid more than 1.9 million unintended pregnancies each year in the United States. (Guttmacher Institute, March 2011).
Q. Where can women who participate in WHP obtain services?
A. Women enrolled in WHP can obtain services from any physician or clinic that participates in the program. Many private-practicing physicians participate in WHP as do Federally Qualified Health Clinics, Rural Health Clinics, and community clinics. Physicians and clinics that participate in WHP must sign a certification attesting that they do not provide elective abortions or bill WHP for referrals to providers who do.
Q. Does WHP promote abortion as a form of birth control?
A. Absolutely not. WHP does not promote abortion or provide coverage of abortions. WHP actually helps Texas reduce the number of abortions by reducing the number of unplanned pregnancies.
Q. Are women who participate in WHP required to choose a particular type of birth control?
A. No. Women who participate in WHP have a choice of many different types of birth control, including natural family planning and abstinence. Women in the program can select the method that works best for them. They can also select no method, if they prefer.
Q. Does WHP provide birth control to minors?
A. No. A woman must be age 18 to 44 to participate in WHP.
Q. Are undocumented immigrants eligible to participate in WHP?
A. No. A woman must be a U.S. citizen or legal immigrant to participate.
Q. If the legislature authorized WHP in 2005, why is legislation needed again?
A. Texas established WHP as a five-year pilot program to determine whether it would be cost-effective. WHP has proven its merit, saving $10 for every $1 in general revenue invested. Unless the legislature reauthorizes WHP, it will expire at the end of 2011. Medicaid costs will increase if WHP comes to an end. In its January 2011 report, Texas State Government Effectiveness and Efficiency, the Legislative Budget Board recommended that Texas continue and expand WHP to help contain Medicaid costs.