The Way Texas Treats Women

https://www.nytimes.com/2017/05/19/opinion/the-way-texas-treats-women.html

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Abortion opponents have long sought to strip public funding from Planned Parenthood and other groups that provide abortions. In Texas, they succeeded.

Lawmakers in other states who want to follow suit should first visit Texas, which offers a case study of the severe consequences of attacks on women’s health.

In 2013, organizations that provide abortions in Texas were cut off from receiving family planning funds. The number of women covered by the state family planning program dropped by 30,000. Reimbursements for long-acting reversible contraceptives like IUDs, some of the most effective forms of pregnancy prevention, fell by more than 35 percent after the exclusion of Planned Parenthood. Pregnancies among women covered by Medicaid rose 27 percent.

To carry out its cuts, Texas had to give up federal money for family planning programs, since the Obama administration would not allow states to exclude specific providers. But now Texas is asking the Trump administration to restore the money. If the application is granted, more states could take Texas’ path.

Experts expect legal challenges, since federal law says patients must be able to use Medicaid at any provider that meets their needs. The change could also require a budget appropriations process in Congress. But this may not keep President Trump or his health and human services secretary, Tom Price, a longtime opponent of Planned Parenthood, from saying yes.

Restoring federal money to Texas would not necessarily bring new health centers to underserved areas where Planned Parenthood and other clinics have closed. Moreover, Planned Parenthood is a trusted provider, known for offering comprehensive and nonjudgmental care. Any program that excludes it, even if fortified with federal money, would unfairly restrict women’s options.

Several states have already followed Texas in directing family planning funds away from Planned Parenthood. This year, Missouri established a program that excludes the group. The governor of Iowa recently signed a bill to do the same.

Now the Trump administration is planning to export this bad reproductive health policy around the world. On Monday, the State Department issued rules expanding the so-called global gag rule, or Mexico City policy, which bars organizations overseas from receiving United States aid if they discuss abortion. Under previous Republican administrations, the policy, established by President Ronald Reagan, applied only to family planning funds, used to pay for contraception and other reproductive health services. The new rules apply to all United States aid for health services, meaning groups could lose money for malaria prevention or AIDS treatment. For instance, $6 billion in funding for H.I.V./AIDS prevention, which goes mostly to groups in Africa, could be lost.

The administration first signaled its intent in January when the president directed the secretary of state to develop a plan to expand the Mexico City policy. At that time, the International Planned Parenthood Federation estimated that it would lose $100 million over four years as a result and be forced to reduce services in at least 30 countries.

Texas offers proof that limiting choices for health services harms women. Unfortunately, the Trump administration is willing to put women and their families at risk in poor countries around the world.