Cutting Family Planning in Texas

Recently, efforts to expand access to contraception through the Affordable Care Act ignited a broad debate regarding the proper role of government in this sphere, and proposals have been put forth to eliminate Title X. In 2011, Texas cut funding for family planning services by two thirds. The Texas legislature also imposed new restrictions on abortion care and reauthorized the exclusion of organizations affiliated with abortion providers from participation in the state Medicaid waiver program, the Women's Health Program (WHP). To implement the legislation and funding cuts, the Texas Department of State Health Services reduced the number of funded family planning organizations from 76 to 41. As part of a comprehensive 3-year evaluation of the legislative changes to family planning policy in Texas, we interviewed 56 leaders of organizations throughout the state that provided reproductive health services using Title X and other public funding before the cuts went into effect. We found that funding cuts led to the closure of 53 clinics and reduced hours at an additional 38. In addition, we found that providers restricted access to the most effective contraceptive methods and implemented systems that require clients to pay for services if they do not qualify for the WHP. Ostensibly, the purpose of the law was to defund Planned Parenthood in an attempt to limit access to abortion, even though federal and state funding cannot be used for abortion care. Instead, these policies are limiting women's access to a range of preventive reproductive health services and screenings