Working to improve Texans’ access to health care in the 84th Texas Legislature
By Anna Chatillon
Policy coordinator for the Texas Women’s Healthcare Coalition
The Texas women’s Healthcare Coalition, of which TAFP is an active steering committee member, is a coalition of 47 health care, faith, and community-based member organizations. We are dedicated to improving the health and well-being of Texas women, babies, and families by assuring access to preventive health care for all Texas women. Access to preventive and preconception care—including health screenings and contraception—means healthy, planned pregnancies, and early detection of cancers and other treatable conditions. The TWHC was formed in response to the devastating legislative budget cuts to women’s health care in 2011.
Now that the prior level of funding has been restored, it is clear the restoration was only the first step toward ensuring that all women in Texas have access to the preventive care they need. Even now, only three in 10 women who need publicly funded health care have access to it. Texas desperately needs to appropriate more funding for women’s health care in the next legislative session. The consequences of failing to provide women access are too high, both in human costs and in financial implications, for Texans to accept.
Myths and political controversy abound, but the facts are clear: most Texans and most doctors agree that women need access to preventive care and contraception. That access doesn’t come easy; contraception is expensive, causing 55 percent of 18- to 34-year-olds to struggle to pay for prescription birth control. This is especially true for the most effective methods, such as long-acting reversible contraceptives, or LARCs, which have 1/20th the pregnancy rate of oral contraceptives. When cost and information barriers are removed, 75 percent of women choose to use LARCs, yet many women are forced to choose other options because LARCs are expensive up front, despite being cost-effective in the long run. This is especially concerning because contraception is a smart financial investment. According to a 2014 report by the Guttmacher Institute, for every dollar invested in contraception, the state saves seven dollars.
State agencies in Texas are periodically reviewed for efficiency and effectiveness by the Sunset Advisory Commission. The Health and Human Services Commission—the umbrella under which women’s health care is housed—is under review this year. Despite the fact that the provider network in Texas has been through multiple rounds of upheaval in the last few years, the Sunset staff recommended that the three streams of state funding for women’s preventive care—the Department of State Health Services Family Planning Program, the DSHS Expanded Primary Health Care program, and the HHSC Texas Women’s Health Program—be combined into one program. Based in part on TWHC’s words of caution, the Sunset Commission recommended continuation of the current DSHS Family Planning program and consolidation only of the EPHC and TWHP programs. This adjustment will greatly help safety-net providers remain financially viable.
This is a critical juncture for women’s health care in Texas. The Texas Women’s Healthcare Coalition believes funding for women’s preventive health care should be increased. More provider training and appropriate reimbursement are needed to increase access to LARCs. The Sunset process must proceed carefully, with sufficient provider feedback and funding.
This session, Texas needs a strong voice for prevention, including contraception. Without that voice, Texan women are in danger of losing access to the care they need.
The Texas Women’s Healthcare Coalition continues to advocate for this important care, educating legislators about preventive care. We are grateful to the membership and leadership of TAFP for your outstanding support for access to women’s health care. For more information about TWHC, or to get more involved please contact Info@TexasWHC.org.