Texas Observer – April 7, 2016
by Alexa Garcia-Ditta
As the summer launch date for Texas’ retooled state-funded women’s health programs approaches, family planning providers and advocates want to know why services like hypertension and postpartum screenings have so far been left off the lists of proposed benefits.
The Health and Human Services Commission released draft rules for the new Healthy Texas Women (HTW) and Expanded Family Planning Programs in early April, detailing the services that each program will cover. The redesign comes four years after the Legislature cut family planning funding by more than two-thirds and then created a complicated, and less effective and efficient, web of services in the wake of lawmakers’ ouster of Planned Parenthood as a safety net provider.
According to the draft rules, the new Healthy Texas Women (HTW) program — a consolidation of what is now the Texas Women’s Health Program and the Expanded Primary Health Care program — will cover birth control, lab testing, vaccines and breast and cervical cancer screenings. The Expanded Family Planning Program will cover the same services, plus prenatal care.
For the last eight months, the Women’s Health Advisory Committee (WHAC) — made up of family planning providers, advocates and physicians — has been working with the agency to retool the safety net ahead of the programs’ July 1 launch.
The benefits lists, though, lack detail on whether things like screenings and treatment for hypertension, high cholesterol or diabetes will also be covered. Dr. Moss Hampton, WHAC member and chair of the OB-GYN department at Texas Tech Health Science Center in Midland, said when patients visit his clinic for a well-woman exam or birth control, they often have other problems like breast lumps, respiratory issues or high cholesterol. Striking the appropriate balance between covering traditional family planning services and primary care is key, he said.
"Why did [HHSC] leave out hypertension, diabetes and cholesterol [screenings] when that was just a big focus a meeting or two ago?” Hampton said. "If you’re going to do a bunch of family planning, you also have to have some funding to take care of other problems that these ladies have.”
Under HTW, poor pregnant women who are on Medicaid will be automatically enrolled in the program after their Medicaid coverage expires 60 days postpartum, a change providers and advocates see as a long overdue way to streamline enrollment so women don’t lose services. An HHSC spokesperson told the Observer that postpartum services will be covered under the new programs, but advocates want that in writing.
"For the health of babies and mothers, and in line with the intent of the programs, it’s important to make clear that, in addition to contraception, HTW and [the Expanded Family Planning Program] also cover screening and treatment for hypertension, postpartum depression, and other key health risks,” said Adriana Koehler, senior health policy associate at Texans Care for Children, in a statement.
Healthcare providers have until April 21 to submit their applications to participate in the new programs. HHSC is taking public comment on the draft rules until April 24 in advance of the next WHAC meeting on April 26.