We support... access to women's health care and family planning services.

• All Texas women deserve access to quality women’s health care and family planning services, regardless of their age or ability to pay
• Funding for women’s health care and family planning services must be increased so hat more low-income Texans can avoid costly unintended pregnancies and can receive physical examinations, health screenings, cancer prevention and detection, and gynecological care, as needed
• All women’s health care and family planning services must be accessible, confidential and provided in a culturally sensitive manner
• A full range of reproductive health care services must be included in health insurance plans to enable individuals to make responsible personal decisions
• All consumers should have full information regarding any services, especially reproductive health care services, that are not covered by their health care plans
• The use of appropriately trained mid-level practitioners, including nurse practitioners, physician assistants and other health professionals assures low-cost, high quality women’s health care and family planning services

Background

Currently, over 100 agencies in Texas provide women’s health care services and family planning in over 500 individual clinic sites in local communities throughout the state. In SFY 1998, over 451,329 low-income women received women’s health care services and family planning at these sites. The majority of these services were made available by Texas Department of Health with a combination of federal funding sources.

Unintended births to low-income women is the leading cause of welfare dependency in Texas. Low-income women cannot become productive members of society, break the poverty cycle or properly care for themselves and their families without the means to control their own fertility. They need the opportunity to make responsible choices about childbearing.

The Need

• Thirty million Texans have no health insurance, and a large percentage of these uninsured are women, including the working poor
• At current funding levels, the Texas Department of Health estimates that there are over 1,677,000 women living at or below 185% of poverty who still do not have access to basic women’s health care and family planning (Texas Department of Health)
• Medicaid paid for 49% of all births in Texas in 1998 (Medicaid Inpatient Report FY1996, Texas Department of Human Services)
• Although down from 60% a few years ago, 49% of pregnancies in the U.S. are unintended, and almost half of unintended pregnancies end in abortion (The Best Intentions, Unintended Pregnancy and the Well-being of Children and Families, Sarah Brown & Leon Eisenberg; Institute of Medicine, National Academy Press, 1995)

The Care

For low-income women in Texas, visits to family planning providers are usually the only medical contact they will have in a year. These women view these providers as their primary health care provider and medical home.

The scope of care provided in the family planning setting mirrors the care provided during a routine gynecological annual visit. It is perhaps the least expensive and, for many, the only means of entry into a health care system. A patient receives a physical examination, method education, counseling, a contraceptive method of choice and health screening for diabetes, anemia, cervical cancer, breast cancer, vaginal infection, hypertension, kidney disease, and sexually transmitted diseases and infections. Treatments are provided on-site or by referral. Many agencies have expanded their services and now provide colposcopy treatment for pre-cancerous conditions of the cervix, hormone replacement therapy and osteoporosis education for older patients, and prenatal care.

Public Support

• A 1996 Lake Research Poll found that 71% of Texans support tax funded birth control services for low-income women
• More recently The Scripps Howard Texas Poll (June, 2000) found that 68% of Texans favor increased funding for family planning services and counseling to reduce the number of unintended pregnancies

The Cost Benefit

The Texas Department of Health has found that for every $1 spent on subsidized family planning services, $3.30 is saved in the first year alone. It only costs approximately $150 to provide women’s health care and family planning services for a full year, including health screening, method education and a family planning method of choice.

In SFY 1997, it cost the state $337 million to provide 153,931 Medicaid paid deliveries, at a cost of $2,200 each. This $2,200 pays only for the delivery and does not include the costs of newborn care and other services provided under Medicaid and other funding sources. If newborn care is included, the average cost is almost $7,000. Many of these expenditures could have been avoided had there been sufficient funding for women’s health care and family planning services to reach a larger percentage of the women in need.

Family planning works. The availability of these services has a positive impact not only on the state budget, but also in the lives and well-being of the women who receive care, by allowing them to make responsible choices.