AUSTIN, Texas -- State lawmakers, hospital system administrators and dozens of women urged Texas officials Tuesday not to sever funding to Planned Parenthood under a law barring state support for clinics affiliated with abortion providers.
A smaller, but no less vocal, number of people opposing abortion turned out to applaud the move during the public hearing.
Officials are working to exclude Planned Parenthood clinics that provide family planning and health services to poor women as part of the Texas Women's Health Program after the Republican-led Texas Legislature passed a law last year banning funds to organizations linked to abortion providers.
Planned Parenthood provides cancer screenings and other services – but not abortions – to about half of the around 130,000 low-income Texas women enrolled in the program, which is designed for women who might not otherwise qualify for Medicaid.
Planned Parenthood has sued, but a federal appeals court ruled Aug. 21 that the state can proceed with plans to cut off funding for it as part of the Women's Health Program, and officials have promised to do so as soon as possible. During the hearing, they presented proposed rules on how to do that.
The federal government had funded 90 percent of the program, which costs about $40 million annually. But it says the Texas law violates federal rules and that it will stop funding Nov. 1. Texas has vowed to continue the program on its own.
The rules, which are expected to take several weeks to implement, say Texas can pay more than $900,000 this fiscal year, $39.1 million in fiscal year 2013, and $13.8 million the following fiscal year to keep the plan going. They also call for expanding coverage for participants to include treatment of sexually transmitted diseases.
The state will obtain the funds for the program mostly by imposing a hiring freeze on state Health and Human Services Commission administrative posts and stepping up Texas' efforts to recover Medicaid funds lost to fraud or wasteful spending.
The state eventually expects to keep the program alive using the White House-backed health care overhaul, which calls for greatly expanding Medicaid eligibility in January 2014. But Sen. Kirk Watson, an Austin Democrat, noted that Gov. Rick Perry has already said Texas won't participate in the Medicaid expansion, which could leave the Women's Health Program hanging.
"We should avoid trying to cobble together funding," he said, noting that the Health and Human Services Commission estimates that without the program, the state and federal governments would have to pay $148 million through fiscal year 2015 in extra Medicaid costs due to rising pregnancy rates.
State Rep. Donna Howard, an Austin Democrat, noted that abortion was a moot point since Women's Health Program rules exclude women who are pregnant.
"None of the women's health providers actually conduct abortions. That is not an issue here," she told the hearing, "and I am concerned about the Legislature and leadership in this state actually holding women's health care hostage to some political agenda."
State Rep. Sarah Davis, a Houston Republican, said she opposed the new rules – and the larger anti-abortion law – on behalf of doctors who fear that regulations restricting physicians from counseling women about abortion options interferes with their ability to provide the best possible care.
"Women's health is not about abortion and not about Planned Parenthood," Davis said.
Randall Ellis of Legacy Community Health Services, which operates five clinics around Harris County, said Texas would be hurting a program that has proved effective.
"We're basically destroying the infrastructure that we have built up across the state to provide family planning services to women," he said.
Planned Parenthood cannot say exactly how many of its Texas clinics may close because of the new rules. It supporters note that the state is among the nation's leaders in cervical cancer rates and that its clinics provide free screenings to Women's Health Program participants – at least for now.
They also point to studies showing that other clinics around Texas would have to increase their patient loads five-fold to make up for care currently provided by Planned Parenthood. Those opposing Planned Parenthood said there are 2,000 clinics and doctor's offices statewide that easily can handle the load.
Abby Johnson said she worked for Planned Parenthood in Texas for years and that the organization openly advocates "elective abortions." Another woman addressing Tuesday's hearing said she went to Planned Parenthood as a college student years ago after becoming pregnant – and that she was given the cold shoulder when she said she'd like to have the baby rather than undergo an abortion.
"It was like a curtain went down over this woman's face," she said of the attendant at Planned Parenthood. "She went from being my friend to being completely closed and glowering at me."
Some of those defending Planned Parenthood, meanwhile, fought back tears as they spoke. Others got angry.
"I'm poor, but I'm not stupid," said Alexis Lohse, a college student at Texas Christian University in Fort Worth who relies on Planned Parenthood for birth control and wellness exams. "This proposal is about one thing: politics."