KASU

Gov. Perry Cut Funds For Women's Health In Texas

Sep 19, 2011
Originally published on September 20, 2011 3:00 pm

Texas Gov. Rick Perry likes to hold out the Lone Star State as a model — his vision for the country. But while Texas' growing economy has been a reliable jobs producer, the state's health care system is straining.

Only 48 percent of Texans have private health insurance, and more than a quarter of the state's population has no insurance at all, more than any other state. To fill this gap, the state's hospital emergency rooms and dozens of women's health clinics have stepped in to serve the uninsured across Texas.

To understand the health care landscape in Texas, it helps to start with context, and perhaps nobody is better suited to explain it than Tom Banning. He is the CEO of the Texas Academy of Family Physicians, a group of about 6,000 doctors whose members reach into every part of the state.

"We've got universal health care in Texas, [but] the way we're financing it is beyond stupid," Banning says.

When Banning says Texas has universal health care, he means if you live in urban Texas and get sick, you can go to the county hospital emergency room.

"In terms of accessing basic primary and preventive care, I think we fall far short," he says.

Over the past eight years, citing budget constraints, Gov. Rick Perry and the Republican-controlled legislature have dropped hundreds of thousands of mostly poor and working-class Texans from the rolls of government-sponsored insurance like Medicaid and the Children's Health Insurance Program. Nearly 6.5 million Texans are now uninsured even though the majority of them have full-time jobs.

Premiums in Texas' unregulated health insurance industry have soared by 105 percent over the past 10 years, according to the federal Agency for Health Care Research and Quality. Texas employers have responded by raising employee deductibles, often dramatically, or by dropping their coverage entirely.

The Effect On Women's Health Care

For hundreds of thousands of Texas women and teens between the ages of 13 and 50, the 71 family planning clinics in the state serve as their gateway to health care, and for many of those women, visiting the clinics is the only time they see a nurse practitioner or a doctor.

Rosalinda Roman, 19, discovered the People's Clinic in East Austin after she got pregnant at age 16 and gave birth to a boy. Now, she comes to the clinic every three months to get her comprehensive well-woman exam and her contraceptive shot.

"I come here and I do my annual physical here. I also get birth control here [and] Depo shot," Roman says. "I don't know what I would do with a second child right now."

With the encouragement of staff at the clinic, Roman has gone back to school and is two months away from becoming a medical technician.

This year, the Texas legislature and Gov. Perry cut funding for family planning clinics by two-thirds. Dr. Celia Neavel is director of adolescent health at the People's Community Clinic in East Austin and says it is a devastating blow.

"That particular funding was used obviously for birth control, but also Pap smears, breast cancer screening, for diabetes, thyroid disorders, anemia [and] high cholesterol," Neavel says.

A 'War On Birth Control'

These cuts are less about saving money and more about abortion and contraception. Evangelicals and Tea Party supporters are ascendant in Texas, and Perry is their champion. These cuts are evidence of their political power as well.

The goal is to get government money out of the abortion process, and if contraceptive services have to suffer a bit of collateral damage in the process, so be it. When The Texas Tribune asked state Rep. Wayne Christian (R-Nacogdoches), a supporter of the family planning cuts, if this was a war on birth control, he said "yes."

"Well of course this is a war on birth control and abortions and everything — that's what family planning is supposed to be about," Christian said.

Family planning clinics are routinely referred to by many Texas Republican legislators as "abortion clinics" even though none of the 71 family planning clinics in the state that receive government funding provides abortions. Texas and federal law prohibits that, but most women's health clinics will refer women or teens who want an abortion to a provider.

"They're sitting here, referring women out to receive abortions," Christian said in an interview with NPR. "Those are the clinics, including Planned Parenthood, we were targeting."

Perry's spokesman did not reply to requests for comment for this story, but Christian said there's no question the Texas governor is an advocate, enthusiastically signing this approach into law.

"Gov. Perry has supported the pro-life agenda consistently throughout his time in office," he said.

The State's Family Planning Solution

The budget cuts to family planning clinics won't in the end save Texas money. The state estimates nearly 300,000 women will lose access to family planning services, resulting in roughly 20,000 additional unplanned births. Texas already spends $1.3 billion on teen pregnancies — more than any other state.

In San Antonio alone, unplanned children born to teens would fill 175 kindergarten classrooms each year. What's particularly galling to family planning advocates is that part of the money, $8.4 million, that was cut from family planning will now go to Crisis Pregnancy Centers around the state. Crisis Pregnancy Centers are part of the pro-life movement's answer to family planning clinics.

The Downtown Pregnancy Center's office in Dallas is located inside First Baptist Church's building, historically one of the most conservative and powerful Baptist churches in North Texas. Although it looks similar to a doctor's office, it is not a medical clinic; there are no well-woman examinations, no contraception services, free or paid, and no Pap smears.

There are 165 Crisis Pregnancy Centers across Texas, and plenty won't take any state money. The Downtown Pregnancy Center doesn't. The centers are for women who are willing to keep their babies or give them up for adoption. But clinic president Caroline Cline says, heartbreakingly, only 1 to 2 percent are willing to let their babies be adopted. Cline says teens will say to her, "I'd rather abort than give my baby up for adoption."

"It's disappointing, it's very disappointing," she says.

The Crisis Pregnancy Centers put up billboards letting frightened pregnant teens know that these are places they can turn to for help, but that can lead to a bit of a misunderstanding. The clinic gets calls from people asking what kind of abortions they offer and how much abortions cost, Cline says.

Nevertheless, these young women are not turned away.

"We let them know that we don't refer for abortion or perform abortions here, but we're a great place to start," Cline says.

The fact that millions of dollars that once went to family planning clinics will, in the future, go to Crisis Pregnancy Centers across Texas causes no small amount of bitterness among those who staff the women's health clinics. It's a feeling they're probably going to have to get used to.

Copyright 2018 NPR. To see more, visit http://www.npr.org/.

STEVE INSKEEP, Host:

It's MORNING EDITION from NPR News. I'm Steve Inskeep.

DAVID GREENE, Host:

And I'm David Greene sitting in for Renee Montagne.

As soon as he became a presidential frontrunner, Rick Perry guaranteed a closer look at his record as governor of Texas. Perry himself has welcomed it. In fact, he's held out Texas as a model for job creation.

INSKEEP: The state's unemployment rate is high but not as high as the nation as a whole. And Texas has been attracting people who move there for jobs.

GREENE: At the same time, though, more than a quarter of the state's population has no health insurance, which is more than any other state. Hospital emergency rooms and dozens of women's health clinics have been filling the gap.

But as NPR's Wade Goodwyn reports, this year Perry and the state legislature drastically cut funding for the clinics.

WADE GOODWYN: At the People's Clinic in East Austin, nurse practitioner Dianne Rainosek examines 19-year-old Rosalinda Roman.

DIANNE RAINOSEK: Looks like you've lapsed on your birth control method, so I'm so glad you're back in today.

GOODWYN: Roman discovered the People's Clinic after she got pregnant at 16 and gave birth to a baby boy. Now she comes every three months. She gets her comprehensive well-woman exam and her contraceptive shot.

RAINOSEK: Are you wanting to restart that method or are there other methods we need to talk about?

ROSALINDA ROMAN: No, I like the Depo shot. It hasn't given me any problems. I've been on it for, you know, two years almost and I like it.

GOODWYN: With the encouragement of Rainosek, Roman has gone back to school and is two months away from becoming a medical technician.

ROMAN: I come here and I do my annual physical here. I also get birth control - Depo shot. I love it, I don't have any problems with it. And I don't know what I would do with a second child right now.

GOODWYN: For hundreds of thousands of Texas women and teens between the ages of 13 and 50, these 71 clinics serve as their gateway to health care - the only time they see a nurse practitioner or a doctor. But this year the Republican-controlled Texas legislature and Governor Rick Perry cut these clinics' funding by two-thirds.

Dr. Celia Neavel runs the People's Clinic and says it's a devastating blow.

GREENE: So that particular funding was used obviously for just strict birth control. But also Pap smears, breast cancer screening, for diabetes, thyroid disorders, anemia, high cholesterol...

GOODWYN: These cuts are less about saving money than about abortion and contraception. Evangelicals and Tea Party supporters are ascendant in Texas. Governor Perry is their champion. And these cuts are evidence of their political power. They want to get government money out of the abortion process and if contraceptive services have to suffer a bit of collateral damage in the process, so be it.

When the Texas Tribune asked Nacogdoches Republican House member Wayne Christian, a supporter of the family planning cuts, is this a war on birth control, Christian said yes.

INSKEEP: Well, of course it's a war on birth control and abortions and everything. That's what family planning is supposed to be about.

GOODWYN: Family planning clinics are routinely referred to by many Texas Republican legislators as abortion clinics, even though none of the 71 Texas clinics that receive government funding provide abortions. Texas and federal law prohibits that. But most women's health clinics will refer women or teens who want an abortion to a provider.

In an interview with NPR, Representative Wayne Christian said that's enough.

CHRISTIAN: They're sitting here referring women out to receive abortions. Those are the clinics, including Planned Parenthood, we were targeting.

GOODWYN: Governor Perry's spokesman did not reply to requests for comment. But Christian says there's no question the Texas governor is an advocate, enthusiastically signing this approach into law.

CHRISTIAN: Governor Perry has supported the pro-life agenda consistently throughout his time in office.

GOODWYN: These cuts to family planning clinics won't in the end save Texas money. The state estimates that nearly 300,000 women will lose access to family planning services. That will result in 20,000 additional unplanned births.

Texas already spends more than any other state for teen pregnancies. In San Antonio alone, unplanned children born to teens would fill 175 kindergarten classrooms each year. And what's particularly galling to family planning advocates is that part of the money, $8.4 million, that was cut from family planning will now go to crisis pregnancy centers around the state. Crisis pregnancy centers are part of the pro-life movement's answer to family planning clinics.

CAROLINE CLINE: And we have three counseling rooms here, and this is where we see our clients and they're all very private and obviously confidential.

GOODWYN: Caroline Cline is president of the Downtown Pregnancy Center. Its beautiful office is located inside First Baptist Church's building, historically one of the most conservative and powerful Baptist churches in North Texas. Although it kind of looks like a doctor's office, this is not a medical clinic. There are no well-woman examinations, no contraceptive services, free or paid, no Pap smears.

CLINE: You can see we have a sonogram machine and everything is private back here as well. And it's also where we do our STD screening...

GOODWYN: There are 165 crisis pregnancy centers across Texas and plenty won't take any state money. The Downtown Pregnancy Center doesn't. The centers are for women who are willing to keep their babies or give them up for adoption. But Cline says, heartbreakingly, only one to two percent are willing to let their babies be adopted. Cline says teens will say to her I'd rather abort than give my baby up for adoption.

CLINE: It's disappointing, it is very disappointing.

GOODWYN: The crisis pregnancy centers put up billboards letting frightened pregnant teens know that these are places they can turn to for help. But that can lead to a bit of a misunderstanding.

CLINE: Lots of people calling just to ask what kind of abortions do you offer, how much does an abortion cost, wanting abortion information.

GOODWYN: Nevertheless, these young women are not turned away.

CLINE: We let them know that we don't refer for abortion or perform abortions here, but we're a great place to start.

GOODWYN: The fact that millions of dollars that used to go to family planning clinics will in the future go to crisis pregnancy centers across Texas causes no small amount of bitterness among those who staff the women's health clinics. It's a feeling they're probably going to have to get used to.

Wade Goodwyn, NPR News, Dallas. Transcript provided by NPR, Copyright NPR.