Lisa M. Hollier, MD, MPH, FACOG
Here in Texas, Latinas and African American women fare worse than their Caucasian counterparts on almost every measure of wellness. So, losing a program that provides vital preventive health care to thousands of low income, minority women - like the Women's Health Program does - is a Texas-sized disaster.
We know disparities in health outcomes for Latinas and African American women are far too prevalent. Consider these troubling stats: According to the Texas Department of State Health Services, African American women are 1.25 times more likely to die from heart disease, 1.6 times more likely to die from breast cancer and 2-4 times more likely to die from complications of pregnancy and childbirth than Caucasian women. For Latinas, the death rate from cervical cancer is 1.5 times higher than for Caucasian women. The vast majority of these cancer deaths can be prevented by timely access to screening and diagnosis, and access to reliable, affordable contraception allows women to plan for and space their pregnancies, which is known to improve outcomes. That's why, here in Texas, the Women's Health Program (WHP) is so important.
WHP provides essential preventive health services to low-income women. Texas has more uninsured, non-elderly women than any other state in the country - 30 percent of women here fit that description! Here in Texas, we have an estimated 1.7 million women of childbearing age who are medically underserved based on poverty, lack of health insurance, elevated health risks or because they live in communities with a shortage of primary health providers. Just two years ago, the Women's Health Program in Texas served more than 100,000 of these low-income women, providing necessary health screenings and counseling about contraception and sexually transmitted infections.
Last year, Texas legislators voted to exclude Planned Parenthood and others affiliated with abortion providers from the Women's Health Program. The State's action is in direct conflict with federal law which assures that Medicaid beneficiaries may obtain covered services from any qualified provider willing to provide the service. Governor Rick Perry's decision means that Texas will lose 90 percent of the funds that paid for the program.
Here in Texas, our Women's Health Program is barely on life-support. - The rules for the new state-run program create obstacles that cripple this valuable program.
Problem 1: These rules place restrictions on doctors that conflict with our ethical duty to provide the best care possible to our patients. The rules prohibit participating doctors from counseling their patients about abortion. This applies not just to patients in the WHP, but ALL patients, and essentially creates a "gag rule" for physicians.
Problem 2: There weren't enough providers to meet the needs of Texas women before the "gag rule" was introduced. In a recent report released by the Geiger Gibson/RCHN Community Health Foundation Research Collaborative, the loss of participation by Planned Parenthood Federation of America (PPFA) clinics would jeopardize access to care for nearly 52,000 low-income women in Texas.
Without access to the preventive services provided by the Women's Health Program, health disparities are likely to worsen for women here in Texas. - Kathleen Sebelius, Secretary of the U.S. Department of Health and Human Services and the nation's top health official, has stated "It is time to refocus, reinforce, and repeat the message that health disparities exist and that health equity benefits everyone." - The current plan here in Texas does just the opposite. Reduced access to services means that fewer breast and cervical cancers will be detected early in their course when they are most curable, and fewer women will find out that they have high blood pressure or diabetes before the diseases have already taken a toll on their health. Losses like these mean yet another step backward for Texas women.
Here in Texas, ACOG will keep advocating for women's health. We join partners and pledge to:
Lisa M. Hollier, MD, MPH, FACOG is Chair of the American Congress of Obstetricians and Gynecologists, District XI (Texas).
This blog post was published in conjunction with Repro Health Watch, an exciting new edition of the Women's Health Policy Report, which compiles and distributes media coverage of proposed and enacted state laws, ballot initiatives and litigation affecting women's access to comprehensive reproductive health care.