When state lawmakers passed a two-year budget in 2011 that moved $73 million from family planning services to other programs, the goal was largely political: halt the flow of taxpayer dollars to Planned Parenthood clinics.
Now they are facing the policy implications — and, in some cases, reconsidering.
The latest Health and Human Services Commission projections being circulated among Texas lawmakers indicate that during the 2014-15 biennium poor women will deliver an estimated 23,760 more babies than they would have as a result of their reduced access to state-subsidized birth control. The additional cost to taxpayers is expected to be as much as $273 million — $103 million to $108 million to the state’s general revenue budget alone — and the bulk of it is the cost of caring for those infants under Medicaid.
Ahead of the next legislative session — where lawmakers will grapple with another tough budget, including an existing Medicaid financing shortfall — a bipartisan coalition is considering ways to restore some or all of those family planning dollars, as a cost-saving initiative if nothing else.
“I know some of my colleagues felt like in retrospect they did not fully grasp the implications of what was done last session,” said state Rep. Donna Howard, D-Austin, who said she has been discussing ways to restore financing with several other lawmakers in both parties.
“A lot of us are talking about this,” she said. “I think there is some effort they’ll be willing to take to restore whatever we can.”
Any such agreement would almost certainly exclude Planned Parenthood from future financing. Though the Planned Parenthood clinics that used to provide state-subsidized care never performed abortions, Republican lawmakers are enforcing rules governing the state’s family planning programs that ban providers “affiliated” with clinics that perform abortions. (By this logic, because some Planned Parenthood clinics provide abortions, none of them can receive state money.)
Sen. Bob Deuell, R-Greenville, has been an advocate for getting Planned Parenthood off of taxpayer financing, but he said last session’s family planning cuts went too far. He said he had the support of some of Texas’ leading anti-abortion groups to seek more money for birth control and reproductive health care in 2013 — as stand-alone services, and as part of what he and Texas health officials hope will be a $70 million expansion of state-subsidized primary care.
“I’ve debated this in Republican clubs with people — people who say it’s not the government’s role to provide family planning,” said Deuell, a primary care physician. “Ultimately, they’re right. But you have to look at what happens if we don’t. We don’t want more abortions.”
The health agency’s numbers, while alarming to some state lawmakers, should not come as a surprise. Last legislative session, while lawmakers debated the cuts, the nonpartisan Legislative Budget Board estimated that they would lead 284,000 women to lose family planning services, resulting in 20,000 additional unplanned births at a cost to taxpayers of $231 million. The cuts passed anyway, a price that socially conservative legislators were willing to pay in their referendum on Planned Parenthood.
The question now, with Planned Parenthood largely off the table, is whether there will be the political will to restore money for birth control, which has increasingly found itself lumped with abortion in Republican debates about family planning.
Asked whether Gov. Rick Perry would support returning money to family planning programs, his spokeswoman Lucy Nashed left the door open.
“Last session the Legislature had to prioritize,” she said, speaking of the state’s budget woes. “Every two years we take a fresh look at our resources and our needs.”