08/10/2012 02:11 pm ET Updated Oct 10, 2012

A Woman's Right to Lose?

When the Affordable Care Act (ACA) a few weeks ago began to provide contraceptive services for women, the plan acquired the kind of traction not possible through political rhetoric. There remain, however, governors and legislators in numerous states as well as at the national level determined to stop full implementation of "Obamacare."

And their political intransigence is certain to create victims.

In Texas, the state's governor and his conservative allies are so vehemently opposed to Planned Parenthood providing family planning and abortion counseling that he his willing to sacrifice federal money used for the Texas Women's Health Program (WHP.) Rick Perry says the state will find a way to pay for WHP without Washington's assistance and will reject the Medicaid expansion that is delivered under Obamacare. This approach means Perry and the GOP will prevent Planned Parenthood from getting federal money through the Texas state government. And he cares more about that political goal than he does the health of women.

Planned Parenthood has filed a federal lawsuit claiming its constitutional rights are being abridged and the entire fight is grim and distracting at a time when women greatly need assistance with health care. As is always the case, however, Rick Perry inadvertently provides dark humor. The governor says that the way Texas will fund WHP services is by using Medicaid expansion funds, which is Obamacare money he publicly insists Texas will not accept. He's already had some success with his cynical notions that the public is not paying attention to his hypocrisies. Perry denounced the Obama stimulus package and then used a few billion of those federal dollars to balance the Texas budget without a tax hike, which set him up for his entertaining presidential run.

Perry and other conservative governors continue to insist they are dedicated to repealing Obamacare and refusing to accept the ACA's expanded Medicaid funding. If they accomplish either of those goals legislatively, there simply will not be a Women's Health Program in Texas, or, likely, any of the other recalcitrant states. Perry presides over an almost irrationally conservative legislature and at least one of its two chambers is certain to reject Medicaid expansion, which will terminate any kind of funding for Planned Parenthood. Texas is scheduled to receive about $100 billion in expanded Medicaid funds and in a state where 1 out of every 4 people lacks health care there hardly seem to be political or logical reasons to reject the money.

Unless you want to eliminate a woman's right to choose.

The Women's Health Program that Perry and the Texas legislature plan to fund has published its rules for public comment and they include what physicians' groups describe as a gag order on abortion and problem pregnancy counseling. Doctors affiliated with abortion providers or who counsel women on abortion or hand out information on abortion or refer their patients to clinics that provide abortions are to be barred from receiving the proposed state money. The Texas Medical Association and four other organizations of women's physicians sent a nine page letter to the Texas Department of Health Services (TDHS) insisting that the rule is tantamount to a gag order, inhibits a doctor's right to deliver prescribed health care, and violates doctor-patient confidentiality. Untold thousands of doctors are likely to withdraw from any program operating under such restrictions and that would seriously further diminish access to health care for Texas women.

And now Perry's government is making false claims in documents to the U.S. Fifth Circuit Court of Appeals, which is hearing arguments in the Planned Parenthood lawsuit. TDHS has filed a document with the court that says the 130,000 women receiving health care through Planned Parenthood will be covered through the state's funded version of WHP in 2013 and then would be eligible for services under the expanded Medicaid program on January 1, 2014. Neither assertion is true. If the legislature includes the ban on abortion counseling for WHP funding, doctors will drop out of the program. The more real possibility is that the measure never makes it through the process and there is no WHP money available. The notion that Medicaid begins to cover those women in 2014 is equally unfounded and absurd when Perry and his consorts vocally insist they are not going to take the expansion money from Obamacare and are dedicated to repeal.

The optimistic standing outside of this process and watching it want to believe that saner minds will prevail. There are huge financial interests in this discussion and they include the usual hospital and physician groups, insurance companies, family and health associations, and budget writers who are dealing with stark realities. Nobody thinks they will allow radical conservatives to destroy helpful programs.

Of course, nobody ever thought Tea Party candidates had a real chance at election, either.

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